Everyone benefits from Medicaid expansion

Want healthy people, healthy communities and a healthy economy? With Medicaid expansion, more people will get care that keeps them healthier and saves lives. Expanding Medicaid will also help Maine’s economy.

Throughout the United States, health care is a growing economic sector but is especially important in states with aging populations like Maine. Our people need health services and this means lots of jobs all over the state.

You can support yourself and a family with a job in the medical field. Often clinics, hospitals and medical practices attract new professionals, many times with families, to Maine, adding to our diversity and energy.

In most of our counties, hospitals are the biggest employers. However, as noted in an analysis by the Maine Center for Economic Policy, hospitals have been hurt by not expanding Medicaid, called MaineCare. In recent years, Maine hospitals have been admitting fewer people with Medicaid and the number without any insurance has increased.

The financial result is strain on Maine hospitals, half of which now operate with a deficit. Only one in three have more than one month’s cash on hand.

And while it’s hard for some to feel sympathetic for hospitals when they’re in money trouble, it ultimately hurts local economies, especially in rural places and former manufacturing towns that really need good jobs.

Mayo Regional Hospital in Dover-Foxcroft. Stuart Hedstrom | Piscataquis Observer

Hurting hospitals translate into fewer services, threatening people’s health care.

In May, Calais Regional Hospital announced it would shut its obstetrics wing, leaving the county with one hospital where women can have a baby.

Then, the very next month, the news came that the only all night emergency service in Jackman would close. Former selectman Alan Duplessis wondered what would happen to local people in need, asking, “Are they going to have family members calling for an ambulance at midnight and not get care until they reach Skowhegan, which is 75 miles away?”

Starting his fall, Mayo Regional Hospital in Dover-Foxcroft won’t have a psychiatrist at their Psychiatry and Counseling Office and dropped a pediatrician at their Family Medicine Clinic. Mayo also has reduced hours when patients can get medical tests for their hearts and lungs. Marie Vienneau, Mayo’s president and CEO, said these changes were “painful” but “were necessary given our limited choices and finances.”

Given these bad effects on services and local economies, it’s a shame that we even have to vote on Medicaid expansion in November. We could have, should have, had it for years.

If only the U.S. Supreme Court had not ruled in 2012 it was up to states whether to expand Medicaid, every state, including Maine, would have done it right away. Still, over 60 percent of states, with Democratic and Republican governors, have expanded Medicaid coverage.

In states that expanded Medicaid, hospitals and health providers see fewer sick people who can’t pay. Nationally the uninsured rate fell to 8.8 percent last year. The financial challenges for hospitals in states like Maine that haven’t yet expanded Medicaid hurt everyone in those communities.

But Gov. Paul LePage repeatedly stopped Medicaid expansion, which has since prompted citizens to gather signatures for this November’s referendum.

If only LePage hadn’t tried to come up a plausible rationale for blocking legislators’ votes for expansion, Maine wouldn’t have wasted taxpayers’ money.

But instead Maine’s executive branch hired Gary Alexander (remember him?) with a no-bid $925,000 contract and in 2014 the consultant put together a plagiarized, poorly done report providing bad arguments against expansion. It was done so badly it had a $575 million math error.

Back then Medicaid expansion opponents tried to do the same thing they’re doing now — attempting to divide us by negatively portraying people who would get covered.

Ignoring the reality that expansion would cover low income working people, one opponent said they should just “get a job.”

But unless the United States adopts a system of universal coverage or raises the minimum wage much higher, there will always be working people who can’t afford insurance.

In fact, Medicaid supports work. Without coverage for care, some would become disabled and wouldn’t be able to work. Among the hundreds who came to the State House in 2014 to stand up for expansion was a farmer-handyman whose hip replacement supported by MaineCare enabled him to stay employed.

Who benefits from Medicaid expansion? Everyone.


Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.