Suppose, just suppose, other states were receiving millions of dollars in federal aid to help support their doctors and hospitals, money that was unavailable to us in Maine.
We’d be sore about that. Outraged would be more like it.
But that is exactly what will begin happening on Jan. 1, 2014, when the federal government begins sending big checks to other states to extend their Medicaid health care programs.
The irony here is that we will not receive our fair share by choice — or, more precisely, our governor’s choice.
Gov. Paul LePage decided during the last legislative session to veto a bipartisan bill that would have allowed Maine, like at least 25 other states so far, to move forward with the federal program.
Although the bill allowing us to participate passed with a bipartisan majority, there were not enough Republican votes to overturn the governor’s veto.
About 70 percent of the people who would have been eligible for this medical coverage are the working poor, people who hold low-wage jobs or do seasonal work for employers who do not provide health care insurance.
That includes single people earning up to $15,856 a year, or a family of three earning up to $26,951.
Remember, that’s “up to” that amount. Many of the people who will be denied coverage make far less.
The governor’s notion is that a family of three earning, perhaps, $16,000 a year, will buy housing, clothing, utilities, maintain an automobile and then have $3,000 to $6,000 left over to buy health insurance.
And that insurance is likely to include $50 co-pays and have a very high deductible before it covers any medical expenses.
That is just not realistic.
Nor will many of these people be eligible for federal subsidies to help pay for health care insurance under the Affordable Care Act.
The federal government has promised to pay 100 percent of the cost of covering these low-income Mainers for three years. After that, the federal match gradually declines to 90 percent after 10 years.
The proposal the governor rejected during the last legislative session would have included a three-year sunset provision, plus it would have required a co-pay for services for those participating in the program to discourage overuse.
That would have been three years of medical coverage for 70,000 Mainers plus 24,000 others who currently receive coverage but will lose it in January — all without any state tax money.
After the first three years, the Legislature would hire a consulting company to analyze the program to see whether it is worth continuing, according to the failed compromise bill.
The Legislature and the person sitting in the governor’s chair at that time could continue or discontinue the program.
Without the program, these people — who are not poor enough to participate in full Medicaid but too poor for the ACA health exchanges — will continue to get sick and, when sick enough, visit Maine’s emergency rooms for care.
When they fail to pay for that care, as most of them will, hospitals will pass that loss back to their paying customers — meaning those of us who work and have insurance.
Last week, the Republican governor and Republican legislature of Michigan decided this program, this support for their doctors and hospitals, was too important to pass up.
Those 25 states, including some with very conservative governors, are moving forward.
We can stubbornly refuse to participate in this program. When we do, the money set aside for Maine will be spent in other states.
We will forgo the opportunity to create an estimated 4,000 health care jobs in Maine.
And we can sit back and watch our money disappear at an eventual rate of:
$701,370 a day.
$5 million per week.
$256 million per year — or about $76 million more than the governor fought hard to repay Maine’s hospitals.
Extending this program may bug the governor philosophically, but as a humanitarian and business proposition, this Medicaid expansion makes sense for Maine.
rrhoades@sunjournal.com
The opinions expressed in this column reflect the views of the ownership and the editorial board.
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