The Universal Notebook: Vote yes to expand Medicaid in Maine

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Question 2 on the state’s Nov. 7 ballot worries me.

The Maine Legislature has voted on a bipartisan basis five times to expand MaineCare (as Maine’s Medicaid program is called) and each time Gov. Paul LePage has vetoed expanding health care benefits to cover 70,000 of our fellow citizens.

LePage puts politics ahead of people every time. That’s why Maine people have put Medicaid expansion on the November ballot. Of course, we have seen recently how this governor and legislature routinely ignore the will of the people on referendum votes.

Question 2 says, “Do you want Maine to expand Medicaid to provide health care coverage for qualified adults under age 65 with incomes at or below 138 percent of the federal poverty level, which in 2017 means $16,643 for a single person and $22,412 for a family of two?”

Medicaid expansion is an ideological battleground. Democrats believe it is the proper function of government to offer health insurance to as many people in need as possible. Republicans wanted the phrase “health care insurance” in the original ballot wording changed to “taxpayer- or government-funded health benefits,” because they do not support much of anything that is “taxpayer-or government-funded.”

The compromise between “insurance” and “benefits” was “coverage.”

Republicans seem to believe the government should deny health care coverage to as many citizens as possible. That’s the only conclusion I can draw when LePage and former Health and Human Services Commissioner Mary Mayhew do everything in their power to dismantle DHHS, and berserk Republicans in Congress try repeatedly to repeal the Affordable Care Act – not to replace it with something better that covers more Americans, but with something worse that covers fewer.

I confess I do not understand the Republican mania to deny people help in the name of tax savings and some perverse tough-love notion of anti-government self-reliance. But then one of the uglier aspects of conservatism is the tendency to make a virtue of selfishness.

So far, 31 states have expanded Medicaid, including some with Republican governors. Maine is one of 19 states – all but one with Republican governors – that have repeatedly turned down federal funds to expand Medicaid. Paul LePage has personally been turning down about $1 million a day for years, such that to date Maine has lost close to $1 billion in federal aid. Talk about cutting off your nose to spite your face.

So 66,000 Mainers signed a petition to put Medicaid expansion to a vote. I will be voting yes on Question 2 not only because expanding Medicaid is the right thing to do morally, but because I take it very personally. Social Security and MaineCare were very important to my parents during the last years of their long lives.

My father worked hard all his life, paid his bills, supported his family and served his country during World War II, the Korean Conflict and Desert Storm, but neither he nor my mother were very skilled at money management. They outlived their retirement by three or four years, which is one reason I oppose Republican efforts to privatize Social Security. When my parents became too sick to stay in their home, MaineCare enabled them to get the nursing home care they needed. I figured they had earned it, but I suppose people like Paul LePage would view it as welfare.

Personally, I look at Social Security, Medicare, Medicaid and the ACA the same way I look at paying taxes to support public schools and public safety. We all pay to support these services so they will be there if and when we need them. We share the risks, we share our resources and we share the rewards.

David Farmer, communications director for Mainers for Health Care, says, “Question 2 will make our health care system fairer and make sure that thousands of Maine people can see a doctor when they’re sick. It will also strengthen our economy by bringing more than 500 million new dollars a year into the state. That money will help our hospitals and clinics to continue to serve their communities. Expanding Medicaid is a good deal for Maine people and for Maine’s economy.”

Not only do I hope Medicaid expansion passes so Maine will no longer be left behind, but I also support the Maine People’s Alliance new initiative to put universal in-home care on the ballot next year. The proposal is to help senior citizens get the care they need in their own homes by placing a 1.9 percent payroll tax on salaries and wages over $127,000.

My family might well have to pay that additional 1.9 percent, but I am more than happy to pay higher taxes in order to assure that more Mainers get the care they deserve.

Freelance journalist Edgar Allen Beem lives in Brunswick. The Universal Notebook is his personal, weekly look at the world around him.

  • jack bauer

    Sorry, I can barely afford to pay for my own outrageously expensive health insurance. I’m voting “NO” to more government spending.

  • Charles Martel

    I’ll be happily and rationally voting “NO” to cancel out your vote. I wouldn’t be caught dead taking direction from Comrade Farmer or the Marxists at the Maine People’s Alliance.

  • Queenie42

    It makes sense to ensure that everyone has access to healthcare. Why? Well, one thing often missing in the debate is the health and wellbeing of the community at large. We all know how we feel when one sick person comes to work and passes their sickness on to others. That’s loss of wages for other employees which could have been prevented.
    We live in a world where a virus could sicken millions if it is not dealt with quickly. Having access to clinics, hospitals, doctors using Maine Care, Medicaid or Medicare makes sense, economically as well as keeping more people from unwanted sickness.
    We do not have any idea what new diseases we, our children and their children will have to face in the future. Instead of being short-sighted, let’s all wish for better and more health care for all. Our family will be voting YES so that more families will be healthier in the future.

    • Mainer1

      The sad thing is most of these people in need don’t work

  • danmaine

    Didn’t we learn anything from our previous history of expanding Medicaid (Mainecare) between lower Federal reimbursements and the Hospital payment crisis that was finally solved by selling off sales of alcohol? Hospitals were under severe financial hardship. We still have Mainecare funding issues and wait lists for those who are poor and disabled and are supposed to be served by this program! It’s difficult to find doctors willing to accept Medicare’s lowered payments, Mainecare’s payments are even lower.

  • farmertom2

    No one in my family needs the expansion and we will all be voting in favor of it because we have neighbors who need this. It’s really pretty simple.

  • Little crow

    Medicaid is a welfare program, not an insurance program, and the idea that expanding a welfare program is going to help the economy is absurd. The expansion will have to paid by the taxpayers, because that’s the government’s only source of money.

    • EdBeem

      So far Maine has missed out on $1 billion in federal funds. Worse, tens of thousands of Maine people have been without adequate health care. Democrats do their best to take care of people. Republicans like LePage just don’t give a damn.

      • Little crow

        Who do you think pays for the federal funds? We do. What LePage wants is to prevent able-bodied people from exploiting a system that’s intended for those who need it.

        • Just Sayin’

          And those who aren’t able-bodied and are caught in the financial crossfire will suffer for it. Additionally, those who needed the assistance and now have to delay or stop care will not only suffer, but will compound their medical costs and expenses. Maine taxpayers are still on the hook for emergency services, which are far, FAR more costly in both human misery and US dollars.

          An ounce of prevention is worth a pound of the cure, as they say. It’s a very true thing in the field of personal health. Making sure everyone has access to proper preventative healthcare is not only the right thing to do, it’s the most fiscally responsible in the long term.

          • Little crow

            I agree that medical expenses become compounded when care is delayed, but LePage’s point is that a Medicaid expansion will open the door for those who don’t need it at the expense of people who, due to Obamacare’s spiraling costs, can barely afford their premiums and deductibles.

            For example, I had a private policy (Maine law prevented me from shopping out of state for a lower premium) that cost $640 a month for $7,500 deductible. I paid cash for everything until I hit the deductible (the cheapest, most basic visit to a doctor costs about $200). Then my insurance company cancelled all policies in the state of Maine, so I had to go on Obamacare, where my premiums almost doubled to $1,180 a month for a $5,000 deductible. We were promised reductions in premiums and this is what we got.

          • Just Sayin’

            Your story of hardship paying for insurance only reinforces why we need more health care assistance, not less. I’m not sure who you think ‘doesn’t need it’ but is getting it. Are you claiming that richer people than you are getting health care through the ACA at some more reduced rate than you? Or are somehow being allowed on medicaid when you’re being denied?

            It’s also worth noting that Medicare and the ACA are separate programs, and don’t go through the same marketplace, so you can’t conflate them as easily as that.

          • Little crow

            The point I was trying to make is that I already had a crappy health insurance policy because the state of Maine and federal government won’t let me buy the insurance I want. I can’t buy insurance from another state, and it has to meet all kinds of mandates that I don’t need. When the ACA came along, my crappy policy got cancelled and I had no option left but to sign up with a crappier one – Obamacare.

            I understand that Medicaid and the ACA are separate programs, but mentioned the ACA to illustrate that the problem with our health care system is too much government interference, not a lack of it. Choices and competition in a free market will control costs and provide more quality and accessibility for everybody, including the poor; as they do with all other goods and services.

            Let me propose this: suppose we provide the needy with whatever it is that they need for health care in a government program, but the rest of us can be set free to buy whatever we want? Is that to much to ask? Just leave us alone so we can buy across state lines and get a high deductible or a low deductible or whatever fits our needs.

          • Just Sayin’

            This is more or less the system we had before, with medicare, medicaid and no ACA. What we found was that poorer americans chose to do without additional health care. This meant that they couldn’t afford a lot of preventative medicine, and allowed health problems to get worse before seeking treatment.

            This not only compounds medical problems and costs, as discussed before, but then these people are waiting until they need emergency services. This is both much more expensive and much more time consuming for medical staff to treat, leading to packed emergency rooms and overcrowded hospitals, which becomes a problem for everyone, no matter what insurance they have.

            I think overall your idea is the right approach, but not easy to work out. I think that there should be a single-payer health care system in place to cover all preventative, essential, and emergency care. If you want to buy insurance on top of that to increase coverage and options in your own health care, I think that’s fine.

            The trick is to decide exactly what’s covered, and how to pay for it. It’s not impossible to do at all, but it’ll take a lot of work to get there. Also keep in mind, the ACA had wealthier people paying higher premiums to cover the needs of the less wealthy, but if we do away with that, taxes will likely go up. The money has to come from somewhere.

  • Little crow

    It is worth noting that this week a federal judge ruled that President Obama violated his own health care law by issuing an illegal executive order to reimburse insurance companies for overages under Obamacare. President Trump reversed this decision, and in doing so has kept within the ACA as written.

    It is also worth noting that the English National Health Service has proposed a policy that will deny surgery to anyone who is obese or smokes. This the “death panel” in Obamacare for which Sarah Palin was mocked. In the ACA it is called the Independent Payment Advisory Board. A decision is no longer just between you and your doctor – the IPAB will decide if you get treatment, depending on whether they think you need it, or whether you are worth the expense.

    The English system is a single payor program, which is the real goal of most who supported the ACA. This is where it all leads: government intrusion into our most private affairs, rationing, higher costs and lower quality.

  • EdBeem

    Yesterday, Maine citizens rejected the selfishness of Paul LePage, Donald Trump and the Republican Party and voted overwhelmingly to take care of one another.