Pharmacy deserts. Rising costs. Workforce shortages and funding gaps. Uncertainty from Washington. And a host of challenges facing health care providers across the state with the country’s oldest population.
Maine’s health care system and the struggles Mainers face gaining and keeping access to affordable care and medicine are already major flashpoints in the wide-open race to replace outgoing Democratic Gov. Janet Mills.
“It’s a mess everywhere,” former Maine Senate President Troy Jackson, D-Allagash, said Wednesday at an Augusta forum featuring nine gubernatorial candidates hosted by the Maine Primary Care Association.
The candidates — four Democrats, four independents and one Republican — all agreed that Maine’s next governor must tackle an increasingly costly and complex health care crisis. Several have already released health plans, though on Wednesday they differed on how and where to focus spending.
Some common themes emerged, including bolstering workforce programs, expanding technological innovation and pharmaceutical delivery options. Democrats were focused on combating both the insurance industry and President Donald Trump’s administration.
“With Donald Trump setting his sights on the state of Maine, this next election has outsized importance,” Nirav Shah, who became a familiar face leading the pandemic response as Maine’s public health chief, said. “It will only be through governors, and the state governments that they lead, where our health, our safety, our welfare, and our rights, are protected.”
Secretary of State Shenna Bellows, a former state senator, touted a bipartisan track record and efforts to fight the pharmaceutical industry and Trump. She said she was passionate about health care in part because she grew up in poverty.
“I think it’s really important that we incorporate health care funding and primary care funding into the governor’s baseline budget, so you don’t have to argue over dollars and cents every single year,” she said. “It should be sustainable, ongoing support to primary care to keep your doors open.”
Jackson redoubled his support for Medicare for all but recognized universal coverage would be hard for Maine to accomplish on its own. He pledged to take on “Big Pharma,” noting his measures on the subject that fell vetoes from Mills — including two in 2021 — due to longstanding constitutional concerns.
“We could be doing that right here in Maine and that would be saving a lot of people money across the state,” he said of an effort to cap costs.
Former state House Speaker Hannah Pingree cited her work as Health and Human Services Committee chair, and success passing bipartisan budgets that invested in lower health and prescription drug costs. She said the health care crisis comes “at the worst possible time” for Mainers, particularly as Trump’s so-called “Big Beautiful Bill” eliminated extensions of Affordable Care Act subsidies and hit struggling rural hospitals with cuts.
“We are the richest country in the world, and yet we have some of the worst health outcomes,” she said. “You need a governor who knows how to get things done to make a difference.”
The independents in the room gestured to the parties as a problem. Addressing the health workers in the crowd, the most prominent one, Sen. Rick Bennett, I-Oxford, said the “political system is not responsive to ordinary people doing extraordinary things.”
“It’s focused on fighting and political point-scoring,” he said.
Independent candidates state Rep. Ed Crockett, I-Portland, and retired Maine state worker John Glowa also called out the insurance and pharmaceutical industries for driving up costs. Derek Levasseur, an independent from Benton, said state spending on health must be guided by the health care community.
Jonathan Bush, the only Republican out of eight vying for the gubernatorial nomination on the panel, said the general business climate must improve to boost the workforce. The former CEO of Massachusetts-based athenahealth and nephew of former President George H.W. Bush should support and regulate but avoid being a “Soviet central planner.”
He also disagreed with most other candidates when asked if the state should expand student loan repayment and financial incentives for clinicians working in rural or underserved areas.
“Heck no,” Bush said. “You’re attracting people who aren’t innovators, who aren’t self-sufficient. You’re taking a very poor state and taking money taken by force in taxes and giving it to some of the richest people in the country who are doctors. That is unfair to people, and it is unnecessary.”