There was no good argument against expanding Maine’s Medicaid program in accordance with the Affordable Care Act. Most lawmakers saw this as they tried again and again to pass expansion over the objections of then-Gov. Paul LePage. Maine voters saw it, too, as they approved expansion at the ballot box in 2017 in all 16 counties and with nearly 60 percent of the vote.
Now Maine is reaping the benefits.
Two years after MaineCare expansion was approved by voters and nearly a year since Gov. Mills put it in place, more than 40,000 low-income Mainers have enrolled.
Overall, the new enrollees are older, more rural and more likely to have a chronic condition than the general population. They are far more likely to be in poor health, and many have not had a recent checkup with a doctor.
Without expansion, most of them would have gone without treatment for heart disease, diabetes, mental illness and other chronic conditions. They would have gone without doctor visits, medications and screenings.
The access they now have to those treatments and services will literally save lives.
According to a new study by the National Bureau of Economic Research, a Massachusetts-based think tank, Medicaid expansion in other states saved an estimated 19,200 lives among people ages 55 to 64 that would have otherwise been lost.
In other words, screenings obtained under Medicaid caught illnesses early that would have otherwise led to death, and people were able to get treatments and medications that held off illness that would have otherwise escalated.
Applying that research to Maine shows about 180 Mainers who died from 2014 to 2017 could have been expected to live if MaineCare had been expanded at the time.
Likewise, going forward, we can expect a similar portion of enrollees to live longer as a result of MaineCare expansion.
We also found out in August that 10 percent of the adults who had enrolled under MaineCare expansion were receiving treatment for opioid use disorder. Providing access to drug treatment was one of the main selling points for expansion, and it is fulfilling that promise.
As of Sept. 30, more than 14,000 new enrollees had received mental health treatment through MaineCare, and another 5,700 have been treated for substance use disorder, again extending proven treatments to people who need them.
What’s more, the governor’s office says spending on the new enrollees is within projections, and that Maine will receive nearly $700 million in federal funding through fiscal year 2021. A lot of that will go toward Maine’s struggling rural hospitals, providing a much-needed boost to these large employers and regional economic engines.
On her first day in office, Gov. Mills put MaineCare expansion in place. She also ended the state’s pursuit of counterproductive Medicaid work requirements, which do nothing but waste money on bureaucracy while denying care to those who qualify.
There is more to do to improve MaineCare. The state must make sure there are enough providers to take care of the influx of patients in a number of specialities, substance use treatment among them. Reimbursement rates are too low in many areas. Mills has already committed to an overhaul of MaineCare transportation program. MaineCare enrollees need a dental benefit to help them stay healthy and participate fully in the workforce.
But expanding MaineCare was a tremendous, long-overdue victory for the health of Mainers and the state economy. We can already see the rewards.
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