Gov. LePage's refusal to accept federal medicaid funds stresses people in need and the our healthcare system

By Ramona du Houx

There are too many people — many of whom have significant health care needs such as mental illness, diabetes and drug use disorders — whose incomes are too low to qualify for subsidies on the Affordable Care Act Exchange. These 70,000 Mainers also don’t qualify for federal Medicaid coverage, known as MaineCare.

While six measures have been tried in the legislature to secure federal Affordable Care Act (ACA) funding Governor Paul LePage has put an end to them all. Not only is this killing fellow citizens it's stressing our healthcare system.

When the ACA passed in 2010, its financing model said that hospitals would contribute financially through reductions in Medicare and in payments the federal government made to help with charitable care. In turn, hospitals would realize increased revenues as uninsured patients gained coverage through the Exchange and expanded Medicaid. And where this is happening in other states, hospitals are seeing profits and more people are healthier, because they have become covered for the first time. The ACA is working, 90 percent of American citizens are covered.

But in Maine, more folks are being forced to use hospitals for everyday coverage needs.

"As a result, we are providing more free care than ever — $ 5.8 million in last year alone. In Maine, hospitals are being forced to pay twice: Once to the federal government through Medicare payment reductions and once as we absorb the increased cost of free care provided to those who might otherwise qualify for Medicaid. We keep hearing how much Medicaid expansion would cost Maine, but it is time to talk about how much the failure to expand Medicaid is costing Maine’s non-profit hospitals and the communities they serve," said Mark Biscone, chief executive officer of Pen Bay Medical Center, Waldo County General Hospital.

While Democrats have led the charge in the legislature to accept ACA funding, some Republican lawmakers have also woken up to the finical benefits. Sen. Tom Saviello and Sen. Roger Katz, understand that turning down hundreds of millions of dollars in federal funding each year would save tens of millions of dollars in the state budget.

Governor John Baldacci in 2010 at a meeting announcing more benifits of his Dirigo Health Care program which helped Mainers who never had insurence become covered. Photo by Ramona du Houx 

Saviello’s bill, LD 633 would have cost the state $93.1 million over three years — an amount equal to about 1 percent of state expenditures over that period. "In that time, the federal government would pump nearly $1.2 billion into the state. That money would ripple through the state’s economy in the form of increased employment in the healthcare sector as well as savings on private insurance premiums," said Bisconne.

In recent years Medicaid funding has been increased nationwide in both 2003-2004 and 2007-2009. Governor John Baldacci was smart enough to take advantage of the increases, when he was in office and created MaineCare, which thousands still rely on, even-though LePage has severely cut the program back. Baldacci also created the Dirigo Health Care Act which became a model for the ACA. Maine was ranked amongst the top ten states for improving healthcare coverage for it's citizens, until LePage was elected. Pres. Barack Obama came to the state when the ACA was passed to congratulate lawmakers on their efforts in healthcare.

The fight to cover 70,000 Mainers in need must continue, along with an effort to understand the pressure the state's non-profit hospitals are under because the state refuses to accept ACA funding. Healthcare was a growing industry in the state of Maine before Gov. LePage.

After the November election let's hope the new legislature will have enough votes to withstand a LePage veto. People need healthcare, and good qualtiy hospitals.

"Maine is fortunate to have its not-for-profit hospitals. They have served as providers of last resort for more than a century, assuring that no one is turned away when they are sick and in need of care. But this system is being squeezed, and our communities are paying the price as mistrust of Washington trumps simple math and economic fact in Augusta," said Bisconne.