Prior experience is a key part of any job interview, so we’re sure Mary Mayhew’s new boss at the U.S. Centers for Medicare and Medicaid Services looked deep into her work history. If so, they would have seen this assessment from the Office of the Inspector General: “Maine failed to demonstrate that it has a system to ensure the health, welfare and safety of the 2,640 Medicaid beneficiaries with developmental disabilities.”
The inspector general’s report covered 2½ years of Mayhew’s tenure as commissioner at the Maine Department of Health and Human Services, beginning two years after she was named to the job – and it did not reflect well on her. Under Mayhew’s lead, DHHS failed to meet its most basic obligations to residents with severe disabilities, hardly a ringing endorsement of the person who now oversees the Medicaid program nationwide.
CUTBACKS HURT MAINE
Maybe, then, it was Mayhew’s response to the opioid crisis that got her noticed in Washington.
It’s clear now that Maine was sitting on a powder keg in 2011, when Paul LePage took office as governor and brought Mayhew with him. At just the wrong time, the two worked to cut MaineCare reimbursements for methadone, a proven anti-addiction treatment, and eliminate health care coverage for thousands of Mainers, including many of the young childless adults who got ensnared in the drug crisis and then couldn’t find or afford treatment.
In that environment, an epidemic flourished, and Mayhew never adequately responded. Even as advocates and medical providers begged for more resources for treatment – and eventually Maine’s death toll from overdose rose to one a day – she said there was no need for it.
Mayhew, too, led the charge to cut the Supplemental Nutrition Assistance Program, or food stamps, and Temporary Assistance for Needy Families, in the latter case stockpiling tens of millions of dollars in federal funding. She reduced or eliminated prescription drug coverage for thousands of seniors, and cut reimbursement rates for services for people with mental illness.
Meanwhile, the lives of the poorest, most vulnerable Mainers got worse, as hunger, poor health and poverty rose relative to the rest of the region and country.
And finally, in what was a microcosm of Mayhew’s time at DHHS, the death of two girls last winter revealed a child welfare system in disarray, its caseworkers and foster parents overburdened. The opioid crisis had taken its toll there, too, as the number of cases involving children in danger jumped, and DHHS under Mayhew’s lead took no steps to expand the system’s capacity as it broke under the pressure.
ONLY MONEY MATTERS
There are more stories like that from Mayhew’s time as DHHS commissioner, and they mostly follow the same pattern: LePage and Mayhew were concerned only with trimming services and cutting budgets.
Mayhew said the cuts were necessary to prioritize spending on the “truly needy,” though they caused seniors, young children and those with disabilities to suffer. She said taking away assistance would force Mainers to be more self-sufficient, though most of those who were cut off faced other barriers to employment that Mayhew neither recognized nor helped lower. As a result, many of the poorest Mainers just ended up worse off, not closer to self-sufficiency.
That’s Mayhew’s resume, and it would be a bad one if she were being hired to help poor people obtain health care. But she’s not – Mayhew is joining an administration that wants to take it away.
The Trump administration sees what happened in Maine – the hunger, poor health and neglect, but with less short-term spending – as a success, and they want it replicated nationwide. Unfortunately, Mayhew’s the right person for the job.
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