Susan Johnston helps coordinate the Election Day canvassing effort at the Mainers for Health Care headquarters, Nov. 7, 2017, in Portland. Voters in Maine decided that year to join 31 other states and expand Medicaid under former President Barack Obama's Affordable Care Act. It was the first time since the law took effect that the expansion question had been put before voters. Credit: Robert F. Bukaty / AP

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Marco Cornelio is vice president of the Maine Academy of Family Physicians and a practicing family physician in Biddeford. Patrick Connolly is a family physician in Portland and a past president of the Maine Academy of Family Physicians. Brendan Prast is a family and preventive medicine physician who practices in Sanford. He is on the board of directors of the Maine Academy of Family Physicians as well as the board president of the American Heart Association of Maine.

Across the country, Medicaid is a safety net for more than 72 million people. In Maine, more than 365,000 adults, children, people with disabilities and pregnant individuals rely on Medicaid, called Mainecare in our state, to access essential health care services that they otherwise wouldn’t be able to afford. Proposals to cut or make other structural changes to Medicaid could have grave consequences for patients and families in Maine.

As practicing family physicians in Maine, we’ve seen firsthand the positive impact Mainecare has had on patients’ lives. Here are a few proof points why this program is so important in our state: Medicaid pays for nearly 40 percent of births in Maine, covers 35 percent of all Maine children, pays for 65 percent of nursing home residents and is the largest source of funding for mental health and substance use care in the state. This means Medicaid helps ensure access to prenatal, maternity and postpartum care; insures children in low-income families and children in foster care; and provides nursing home and community-based services for seniors and people with disabilities.

Any cuts to Mainecare would negatively affect the people in Maine who need it the most. Rural health care is already under fire in Maine, making Mainecare a critical avenue to health coverage for children and families in these underserved areas. Rural communities, where people are more likely to be uninsured and face challenges in accessing care, need fully funded Medicaid.

In our communities and in this state, Mainecare has consistently improved health outcomes at the individual, family and community levels in the short and long haul. Whether you are seeking maternal care, dental care, vaccination against harmful diseases, trying to keep up with cancer screenings or setting up end-of-life care for a loved one, chances are Medicaid is what makes your care possible.

As our senators on Capitol Hill debate cutting Medicaid funding, we want to highlight why we must work to preserve this program at all costs.

First, slashing already-low Medicaid payment rates would make it even harder for health care professionals in Maine to provide care to people covered under Medicaid. Instead, such cuts would ultimately likely i ncrease health care costs as patients are forced to forgo vital preventive care. Reducing funding or further restricting eligibility for Mainecare would not only limit access to care but also exacerbate existing health disparities, leading to poorer health outcomes and increased health care costs in the long term. Additionally, further attempts to add a work requirement to Medicaid eligibility would cause more Mainers to needlessly lose coverage, yet only increase costs overall, as we’ve seen in other states. 

Furthermore, cutting Medicaid could cause a domino effect on health care in Maine. As patients lose Medicaid coverage and access to care, more rural hospitals, physician practices, clinics and nursing homes may be forced to close. With these closures, a substantial number of health care workers will lose their jobs.

As costs are shifted out of Mainecare, all insured patients across the health care system would experience higher insurance premiums. Medicaid cuts would put patients (across all insurers) and states between a rock and a hard place — forcing patients to choose between getting health care or putting food on the table and forcing states to choose between cutting services or raising taxes.

Our job as family physicians is to provide health care for all patients — from infants to sick children to loved ones in nursing homes. That’s why we are asking leaders in Maine to reject Medicaid funding cuts. As Sens. Susan Collins and Angus King prepare to vote on the federal budget during the reconciliation process, we urge them to heed the calls of physicians and patients across the state and recognize that Mainecare is not a handout but a lifeline.

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