Succeeding on health care in 2020

It’s all too easy to give up on politics, to grow cynical, but succeeding politically can mean saving lives, literally.

Gov. Janet Mills knows this. When Mills was sworn into office nearly a year ago, she invoked a dear friend, Patty, who, she said, lacked insurance and “died needlessly from breast cancer, a disease that could have been diagnosed early, treated, and cured.”

You may know a Patty (or perhaps a Patrick) whose sickness was caught too late because they didn’t have coverage. Their loss leaves grief and a gap in their families and communities. And that ache is amplified because their death could have been prevented.

In this Jan. 2, 2019 file photo, Gov. Janet Mills delivers her inaugural address after taking the oath of office at the Augusta Civic Center in Augusta, Maine. (AP Photo/Robert F. Bukaty)

Once in office, Mills took action, saving lives by expanding Medicaid. By late October 2019, 40,000 Mainers got coverage due to Medicaid expansion.

This matters. Studies have shown that Medicaid expansion leads to earlier cancer diagnosis and treatment, better mental health and opioid treatment, and more care for people with heart disease.

Maine could have expanded Medicaid years earlier, but former Gov. Paul LePage blocked it. LePage vetoed expansion multiple times. And when Maine voters backed expansion by a 59-41% landslide, LePage continued to block it. LePage was sued and a judge ordered him to expand but he still refused

It took political success to succeed on Medicaid expansion. Mills was elected governor in 2018, as Democrats took the state Senate and gained larger majorities in the Maine House. The new leaders in the Maine Legislature, House Speaker Sara Gideon and Senate President Troy Jackson, strongly backed expanding coverage. 

Health care mattered for congressional races, fueling the blue wave and flipping the U.S. House of Representatives to Democrats. Advocating greater coverage and protecting care for people with pre-existing conditions, Democrat Jared Golden won in the 2nd Congressional District, defeating Republican Rep. Bruce Poliquin, who voted to repeal the ACA and replace it with something worse.

Looking back, it’s incredible that the Tea Party campaigned against the Affordable Care Act by claiming that it hurt people

Most famously, Sarah Palin said old people and people with disabilities would have to go before “death panels” where “bureaucrats can decide, based on a subjective judgment of ‘level of productivity in society,’ whether they are worthy of health care.” 

Politicians’ fear-mongering was repeated by angry, anxious citizens. At a town hall meeting hosted by Rep. John Dingell of Michigan, a father of a child with cerebral palsy proclaimed that, under the ACA, there would be “no care whatsoever” for his son, and told Dingell “You’ve ordered a death sentence to this young man.” When a woman with disabilities advocated for the law, another attendee told her, “They are using you. You’re stupid. They’re going to euthanize you.” 

That unfounded fear helped Republicans win elections in 2010 but it didn’t stop health reform from passing and people from benefitting. Through the Trump years, the Affordable Care Act has been seen favorably and now only 41% view it unfavorably.

In Maine, more people are insured. Uninsured rates among the non-elderly have dropped from 15.9% to 11.5% in 2018. 

And momentum is now on the side of building on and going beyond the ACA, to cover more people, limit costs, and rein in pharmaceutical companies. 

These goals are shared by all of the Democratic presidential candidates even if they disagree about how to do so, with national polls show more support for a public option than a single-payer system.

Next year the Maine Legislature will consider bills that would cover more low-income working people, provide care for pregnant women with substance use disorder and limit insurance companies’ ability to deny certain types of care. 

Unfortunately, not even past gains are safe. Congressional Republicans and the Trump administration tried to repeal the Affordable Care Act. Trump backs a federal lawsuit to rule the law unconstitutional. 

Thus 2020 will be yet another election when health care will be on the ballot, and who succeeds politically matters for people’s very lives.

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.