New report dispels myths about MaineCare

BY RAMONA DU HOUX

January 9th, 2012 

“As the research demonstrates, many of the people who receive care through this program suffer from serious and chronic conditions that require medical attention,” said Dr. Coleman, a geriatric physician as well as an attending physician at the Geriatric Assessment Clinic at Maine Medical Center. “Without MaineCare, these patients will be less likely to receive appropriate and timely care, making their conditions much worse.”

The report where this research is documented was published by Maine Equal Justice Partners. The report analyzed MaineCare’s Childless Adult Waiver program, which provides health insurance for low-income adults in the state.

“The public debate around MaineCare has been driven by political rhetoric and anecdote,” said Sara Gagne-Holmes, executive director of Maine Equal Justice Partners. “As the Legislature considers Gov. LePage’s proposal to eliminate health insurance for low-income adults, we think it’s critical that lawmakers have an accurate understanding of who is served by the Childless Adult Waiver.”

“The new research provides further evidence that the governor’s proposal to throw 65,000 people off of health care is irresponsible and dangerous,” said Rep. Mark Eves, D-North Berwick, the lead House Democrat on the Legislature’s Health and Human Services Committee. “If we throw these individuals off of health care, they will be forced to seek more expensive emergency room care, and private insurance payers will be left with the bill.”

Prepared in conjunction with Professor Sandra Butler, Ph.D., at the University of Maine School of Social Work, and Dr. Laurel Coleman, the report, “Preserving MaineCare Coverage for Low-Income Adults: Smart Policy-Common Sense,” includes qualitative analysis of the program, interviews with people who receive health insurance coverage through the program and a review of both national and state research about the importance of coverage for low-income adults.

Despite rhetoric to the contrary, the report finds that Maine is not an “outlier” among states for providing health insurance coverage for low-income childless adults. Instead, Maine is one of 20 states offering some form of coverage. Beginning in 2014, all states will be required to provide Medicaid coverage to this group under the Affordable Care Act.

Key findings from the report include that 60 percent of recipients of MaineCare health insurance are 35 or older; 43 percent are 45 or older; and 47 percent have serious medical conditions, such as cancer and diabetes. Recipients of the public health insurance must earn at or below 100 percent of the federal poverty level, which is $10,890 a year for one person.

The report also says that eliminating MaineCare for low-income adults would be a cost savings of $22 million. The result will be a loss of $37 million in federal dollars that the state receives to provide the services.

Of members receiving services:
47 percent fall into a major diagnostic grouping of disease or cancer;
24 percent have a diagnosis categorized as a mental disorder;
11 percent were treated for injury or poisoning.

Dr. Coleman reviewed the medical conditions of a sampling of MaineCare patients.

“Eliminating health insurance for this population won’t make their health care needs go away. Instead, it will make it much more difficult for many people to regain their health, maintain employment or return to the workforce,” said Dr. Coleman. “Policymakers face many hard decisions, but before they decide to eliminate this program they should understand the implications.”

In addition to the personal consequences of eliminating the program, the savings attributed to the cut are a mirage.

“Eliminating health care coverage won’t make these individuals healthy,” said Gagne-Holmes. “Instead, it shifts the costs to communities, hospitals and people with private insurance. Additionally, it will result in the loss of about $37 million in federal funding, which helps to defray the cost of care. If the program disappears, the full cost will be carried by Maine.”

As the research shows, the childless adults covered by MaineCare are among the poorest people in the state. To qualify for help, they must have income at or below 100 percent of the poverty line. They also tend to have serious medical conditions that limit their ability to function without care.

“The proposal to eliminate coverage for childless adults is irresponsible and dangerous, and unnecessarily puts at risk thousands of people,” added Gagne-Holmes.

Maine Equal Justice Partners is a nonprofit legal aid organization that works to find solutions to poverty. It is the leading organization in Maine for independent research and analysis of Maine’s safety net programs, and a trusted source for nonpartisan information on TANF, MaineCare, General Assistance and other aid programs.