The most compelling argument for expanding Medicaid to cover about 70,000 more people is the simplest.
The people are here. They will get sick. When they do, they will receive care they cannot afford.
That’s not liberal or conservative; that’s just reality. And that fact leaves only one question: Who will foot that bill?
Will we do it ourselves, or will we accept federal money to help?
Individually, we may not know any of these sick people, and we may even think them undeserving.
Regardless, our medical system will treat them. It will be expensive and those of us with private insurance and our employers will largely pick up the tab. It’s been happening for years and it partly explains why your hospital bill always looks like someone inserted a spare zero.
Back in 2009, the U.S. Congress passed the Affordable Care Act. Like it or not, it is the law and will likely remain so for at least several more years. Like the law or despise it, it is the current reality.
The law requires the federal government to use tax money to help extend health insurance to more people who don’t have it, including people close to but above the poverty line.
The federal government will pay 100 percent of the cost of doing this for three years, and 90 percent after that.
We can debate the wisdom of this program, and even its sustainability, but this nonpartisan fact remains: The offer is there now, and we can take it or refuse it.
Maine would receive $250 million in new money annually, and accepting it would allow us to retain an additional $82 million that would be lost annually if we did not.
If we refuse, it won’t reduce our federal taxes one whit, jot or iota. The money meant for Maine will simply go to another state or be spent on other federal programs.
There are 37 hospitals in Maine, plus countless doctors, nurses, pharmacists and therapists who work outside hospitals.
The new money would turn over tens of times in our communities, ringing cash registers and creating thousands of new jobs.
Whether the program would cost Maine money is hotly debated, and critics tend to focus only on the expenses and not the obvious financial benefits.
The expansion would open opportunities for the state to shift people from programs now paid for by the state to those paid for by Medicaid. Maine could move people from services reimbursed at a 62 percent rate, to 90 or 100 percent. In some cases, the cost of health care for people in Maine’s prisons could move from the state to Medicaid.
It is hard to say how all the pluses and minuses would work, but a variety of expert sources have predicted Maine would save money by expanding Medicaid.
For those who still have concerns about how this would work out in the long run, the program even has an escape hatch. Maine can drop out at any time.
One of the proposals before the Legislature even includes a sunset provision that would require another vote in three years when the program shifts from 100 to 90 percent funding.
There has been a lot of hyperbole in the campaign against expanding MaineCare. Among the arguments: The cost of the MaineCare program is “exploding” and out of control.
But the Maine Hospital Association points out that total spending for MaineCare was the same in 2013 as it was in 2009. Over the long haul, spending has grown by about 3 percent per year.
Several legislators have painted a picture of recipients spending wildly with their MaineCare cards.
Actually, 80 percent of MaineCare recipients use less than $1,000 in health care services a year and we spend less per recipient than any other New England state.
It may, of course, be impossible for legislators to put partisanship aside in this decision, and that is unfortunate.
Most research done by credible, nonpartisan organizations shows Maine saving money, saving lives and improving the health of thousands of people.
There is a bottom line to this debate.
After analyzing the risks and benefits of expanding Medicaid in 14 states, the mathematicians and experts at the RAND Corp. said this:
“Our analysis shows it’s in the best economic interests of states to expand Medicaid under the terms of the federal Affordable Care Act. States that do not expand Medicaid will not receive the full benefit of the savings that will result from providing less uncompensated care.”
rrhoades@sunjournal.com
The opinions expressed in this column reflect the views of the ownership and the editorial board.
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