More needs to be done to improve access to affordable health care coverage. Mainers and people across the county made that loud and clear as they pushed back on the GOP’s proposed replacement of the Affordable Care Act. This failure amplifies the success of the Affordable Care Act in improving access to affordable and comprehensive coverage — it remains “the law of the land.”
Maine can take steps to improve affordability of health coverage. In fact, the Legislature is considering another bill to accept federal funds to expand the state’s Medicaid program, also known as MaineCare. There are several factors at work this year to allow lawmakers to garner the needed votes to overcome a likely veto by the governor, and if not Maine voters will have their say this November.
First, there is bipartisan support for Medicaid expansion. While some congressional GOP leaders and Gov. Paul LePage have remained fierce adversaries of the Affordable Care Act, the tide in Maine, as in most of the country, has turned. As the governor and his most ardent supporters object to expansion, the ground erodes beneath them faster than they can fabricate new arguments.
States that chose to expand Medicaid are faring quite well. None of the 31 states that expanded their Medicaid program have pulled out even though they can at any time. Republican governors from expansion states strongly urged Congress not to repeal Medicaid expansion. It seems that good health is good for the economy as well.
While some continue to argue Maine can’t afford expansion, New England states and other expansion states have found the benefits far outpace the costs. Millions have been given access to health care and state budgets have experienced a boost. The New Hampshire Hospital Association found that emergency room visits fell 30 percent after expansion, and new federal funds could be used to address the opioid epidemic, saving taxpayers millions of dollars. Michigan has realized $235 million in savings from expansion as it uses new federal funds to replace state funding for community and correctional mental health services. Kentucky is forecast to see an estimated $819.6 million positive impact by 2021. Audrey Tayse Haynes, who served as secretary of the Kentucky Cabinet for Health and Family Services, said, “I don’t know any other way of describing it except as a win-win for us.”
The Maine Center for Economic Policy’s forecast tells a different story about the fiscal impact of Medicaid expansion than our governor’s dire warnings would indicate. It estimates Maine would receive more than $320 million in new federal funds annually once Medicaid expansion is fully implemented. Our state would also experience at least $26 million in budget savings. These figures don’t include additional tax revenue that would be generated by the more than 3,000 good paying jobs that would be created. More than 12,000 health care-related jobs were created in Kentucky during the first year it expanded its Medicaid program, and the job growth there continues. The ripple effect to Maine’s economy would likely be enormous. Since enactment of the Affordable Care Act, the governor and his allies have left more than a billion tax dollars sitting in Washington, D.C., instead of being spent here in Maine.
One overarching issue can no longer be ignored. The opioid epidemic has focused attention on Maine’s lack of coverage for people in need. Expansion would provide Maine with much needed resources to build upon our treatment options and improve access to treatment for the many who have been left out in the cold.
The state also would save money in its criminal justice system. Other states, including Ohio and Illinois, are using expansion funds to provide drug and mental health treatment to prisoners once they are released, which in turn lowers relapse rates and recidivism. Medicaid expansion funds can be used to provide services through drug courts, which have proven effective in reducing recidivism and incarceration and in reducing health care costs.
Medicaid expansion would be an opportunity to provide affordable health care for nearly 70,000 Mainers, including 3,000 veterans and many others who work low-wage jobs who aren’t offered coverage or who can’t afford it. This truly would be a “win-win” for Mainers and the economy of our state.
Arthur Barry Adoff of Veazie is a writer and graduate student at the University of Maine School of Social Work. Jesse Call, Harry Ward, and Lu Ruyi, who are graduate students in the UMaine School of Social Work, also contributed to this piece.