At the Maine Health Access Foundation, we talk with people from all across the state about how physical and mental health issues affect kids, grownups, families and communities, and how getting care is incredibly difficult for people without health insurance.
Just last week, I read a grant application from an organization in a small town in Maine (we’ll call it “Laketown” to preserve anonymity) that brings to life these stark — and sometimes tragic — challenges.
Laketown, which has a population of about 1,000, thrives on its tourist industry and is home to several historic landmarks and beautiful natural resources. In the past 18 months, Laketown has experienced a series of deadly events. Several overdose deaths, a middle-school student’s suicide and an alcohol-related death came in quick succession.
Families in Laketown struggle, with many people working a couple of jobs to make ends meet. The local health center staff knows that many people in the community, especially those with lower incomes, simply do not seek care for physical or mental health problems because they don’t have health insurance. When people delay or don’t seek care for addiction, depression or other chronic conditions, the outcomes can be fatal.
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A recently completed data brief provides hard numbers to back up this story. For many low-income Maine adults, basic elements of physical and mental health care are far out of reach because they do not have insurance coverage. The brief, from the University of Southern Maine and the Maine Health Access Foundation, shows that if you live in Maine and your income is below 138 percent of the federal poverty level, you face real problems getting health care, especially if you are uninsured.
Over half of uninsured, low-income Maine adults in the survey said that they had trouble paying medical bills. One in 4 had difficulty finding a health care provider, and 1 in 5 was not able to find a provider who would accept him or her as a new patient. Over half did not have a usual source of care. Many delayed or went without medical care or necessary prescription drugs.
In contrast, Maine people of the same income level with health insurance report better access to needed health services. While many individuals with insurance experienced some barriers to care, they did so at about one-half to one-third the rate of their uninsured neighbors, friends and co-workers.
Maine has a solution to address some of the challenges of access to care in Laketown and other communities around the state. The insured low-income people included in the survey primarily had health insurance through Maine’s Medicaid program, known as MaineCare. MaineCare made a difference in their lives and their health. With the November 2017 decision by Maine voters to expand MaineCare, there is a path for some uninsured adults in Maine to get coverage to help them pay medical bills, get check-ups and not delay care.
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There is no question that making changes to big programs like MaineCare requires careful consideration. A new report released by the Maine Health Access Foundation from national experts Manatt Health provides detailed information that can help Maine’s decision-makers as they implement expansion. Expanding MaineCare coverage can help many thousands of Maine residents in Laketown and beyond stay healthy and productive.
I can’t say whether the recent tragic losses in Laketown were specifically linked to lack of insurance. But I can say that I hear stories every week from grantees and partner organizations around the state about patients and clients who don’t have insurance and have suffered loss of health, employment or worst of all — loss of life.
People in Maine work hard, are independent, and want to retain their personal control and dignity, especially when it comes to their physical and mental health. Having health insurance is one way to help them do so. When we think about it this way, health insurance is not a luxury, and we all pay the price when our family members and friends don’t have coverage.
Barbara Leonard is president and CEO of the Maine Health Access Foundation.
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