Expanding Medicaid is the hot topic in Augusta ”“ and around the nation ”“ these days, since the federal government offered up 100 percent of the costs for three years in conjunction with the Affordable Care Act.
Now, lawmakers in Maine are fighting over whether the costs will truly be covered, and making almost daily statements on why the expansion would be a good or bad thing.
The Republican camp is saying the expansion is not “free,” as is Maine Department of Health and Human Services Commissioner Mary Mayhew. Mayhew said in a recent statement that the Office of Fiscal and Program Review’s analysis neglected to take into consideration financial information provided to them by the DHHS.
Democrats say the expansion will insure tens of thousands of people in dire need of health care. They also call into question the governor’s cost projections, which were outlined in a report sought by his office and completed by the Alexander Group.
The nonpartisan Office of Fiscal and Program Review, which analyzes legislative costs, estimates the bill that would allow for the expansion would cost about $683,520 over the first three fiscal years, according to Associated Press reports. The LePage administration, however, says the expansion will cost $84 million by 2017, and agrees with Mayhew that the OFPR analysis did not use the proper data from the DHHS.
It’s clear this issue is extremely divisive.
The bill being considered now, crafted by two Republican senators, would also tie the expansion to implementing a managed care system in the state’s Medicaid program. That would entail bringing in a company ”“ through the bid process ”“ to run the program.
Mayhew said in a recent meeting with the Journal Tribune Editorial Board that she is against both the expansion and the managed care system, and she wants to focus the DHHS’ remaining resources on programs that are already in place and have lengthy waiting lists ”“ like home health aides for the elderly and programs for adults with developmental disabilities and mental health issues.
This is a good goal, and it’s heartening to hear Mayhew speak about the programs the department is working on and trying to stabilize. She says these two groups are going to be in serious trouble without a plan in place to get them the care they need.
Maine’s elderly population is set to expand in the coming years as baby boomers retire, and to keep them healthy and in their homes ”“ instead of in nursing homes ”“ is Mayhew’s goal. But, she said, there are still major costs to do so, and the expansion of Medicaid will use up all of the future funds available for such programs when the federal funding runs out.
“We do not live in a world of unlimited resources,” Mayhew said, adding that the majority of the people who could be added to Medicaid under the expansion would qualify for subsidies under the Affordable Care Act’s health insurance exchange.
Enroll207, a project of the Maine Health Access Foundation, reported this week that 89 percent of Maine’s enrollees through the marketplace qualified for some level of financial assistance that lowered their monthly and out-of-pocket costs. Mayhew said those who would be covered by Medicaid under the expansion would likely qualify for similar assistance, and it would be very difficult to transition those people off of Medicaid in three years and into private insurance plans.
Even though the money for the Medicaid expansion is coming from the federal government for the first three years ”“ starting Jan. 1, 2014 ”“ there will surely be major additional costs after that money runs out, and kicking people off of the insurance they have come to expect and rely upon is not a good solution to the money problem.
People need to get used to paying for medical and health services. They can do so at a reduced rate ”“ if they meet financial guidelines ”“ through the health insurance marketplace. Signing up for their own plans will get them the care they need, and get them used to paying copays and other costs associated with staying healthy. Although signing up the majority of the uninsured population will surely be a challenge, it’s the best way to proceed at this time.
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Today’s editorial was written by City Editor Robyn Burnham Rousseau on behalf of the Journal Tribune Editorial Board. Questions? Comments? Contact Managing Editor Kristen Schulze Muszynski by calling 282-1535, ext. 322, or via email at kristenm@journaltribune.com.
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