We’ve seen Gov. LePage’s plan to fill the budget hole in the Department of Health and Human Services. Now we are ready to see something else.
The governor proposed dropping health insurance for 65,000 of Maine’s most vulnerable people, including the elderly, disabled, veterans, families and the homeless.
The Legislature has already signaled that it would push back on the most outrageous cut, ending state support for residents in assisted-living facilities, but lawmakers should not stop there. As members of the Appropriations Committee meet in the days ahead, they should look for ways to address the budget shortfall without causing the unnecessary suffering for short-term gain that the governor has advocated.
The plan before the Legislature still includes elimination of coverage for very-low-income childless adults, referred to in Augusta as the “non-categoricals.” This would wipe out progress the state has made in avoiding unnecessary visits to emergency rooms by people without the ability to pay. When excessive uncompensated care costs are spread out among patients with private insurance, the cost of everyone’s health care increases.
LePage also proposes raiding the Fund for Healthy Maine, ending preventative public health programs that help people quit smoking and get off drugs. Canceling prevention programs when medical costs are already too high just doesn’t make sense.
And LePage has proposed cutting or eliminating programs that help Maine-Care patients pay for prescription drugs, including ones they cannot live without, such as insulin for diabetics. This is apparently the “free lunch” the governor was referring to in his State of the State speech Tuesday.
LePage has shown impatience with the legislative process and has not demonstrated much appetite for compromise.
But even he has said he would make other cuts if he doesn’t get what he wants. His alternative — shutting down the state’s schools — is not an improvement, but at least shows that there is more than one way to address this problem.
The governor is right when he says that he inherited the high cost of the MaineCare program and he did not “invent” it. What we are seeing in Maine is a result of the national crisis of rising health care costs made worse in Maine because of our low incomes and aging population. But that does not mean the governor’s proposal is the only way to deal with the high cost of the program. Other states have encountered the same problem and taken steps to lower their health care costs, and their experience could be helpful here.
New York has redesigned its Medicaid program with 78 reforms that have been built into the state budget. They include using managed care to control long-term care costs, which could be a good approach for Maine, where 5 percent of Maine- Care recipients incur more than half of the costs.
North Carolina saved nearly $1 billion in three years by placing Medicaid enrollees in a program that emphasizes primary care practices that coordinate with other providers. That could also be a way for Maine to provide health coverage at a lower cost.
Another alternative was proposed in Maine last week by a coalition of groups including the Roman Catholic Diocese of Portland, and it deserves serious consideration.
They proposed scaling back tax cuts for Maine’s highest income residents as a better alternative to dealing with this crisis than cutting services for the most needy. Lawmakers should not eliminate this or any other idea when they do the hard work of passing a bipartisan budget amendment.
Gov. LePage and his administration have offered one way to get the job done, but it is not the best way and it is not the only way.
Lawmakers from both parties should do the work necessary to find a better way to close the hole in the state’s medical safety net budget.Gov. LePage and his administration have offered one way to get the job done, but it is not the best way and it is not the only way. Lawmakers from both parties should do the work necessary to find a better way to close the hole in the state’s medical safety net budget.
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