The fierce debate about whether to expand MaineCare services through the Affordable Care Act has been raging in Augusta for nearly a year. Democrats say the plan would cost the state nothing for the first three years, but Republicans and the Commissioner of the Department of Health and Human Services say that not only is it not free, but expanding Medicaid could swallow up state money that could be used to help Maine’s most vulnerable citizens.
Part of the LePage administration’s opposition to Medicaid expansion is the state’s current inability to take care of the elderly and severely disabled among us. Many of them have been languishing on wait lists for critical services for years.
“We’re talking about elderly parents in their 80′s caring for their 55-year-old son with Downs Syndrome. Their health is declining and they are scared about how they’re going to continue to take care of their son, and when they’re not around where is their son going to go,” DHHS Commissioner Mary Mayhew told TV5 Thursday.
Mayhew also says that in addition to prioritizing those on the wait list, the state needs to start preparing for a new crop of Mainers who are being diagnosed with autism every day, people who will soon be aging out the school systems and need to rely on state services.
“And we have an adult system that is not prepared to effectively meet those needs,” Mayhew said. “We’ve got to be planning for those costs coming down the road. We’re not investing the resources that are needed and we cannot afford to expand Medicaid at 100,000 new individuals who are able bodied adults at a cost of over $800 million and ever hope to prioritize resources to support our most vulnerable.”
The numbers Mayhew is using, both in terms of new enrollment and the cost to the state, come from the controversial report from the Alexander Group, which factored in variables such as employers who may stop offering insurance benefits to their workers in hopes they’ll move toward Medicaid or subsidies offered through the Affordable Care Act. The Alexander report has been questioned by Democrats in Augusta who are now trying to defund the contract. House Speaker Mark Eves says he’s committed to helping Maine’s disabled population, but argues expanding Medicaid and taking care of the Mainers on those wait lists are two separate issues.
“What we can’t do is to pass up on this opportunity that provides healthcare to 70,000 Mainers. That injects nearly $1 million into our state’s economy every single day. The stakes are too high. Lives are on the line,” Eves said.
New Hampshire and Utah are two of the latest traditionally Republican states to reach an agreement on Medicaid expansion. Mayhew says there’s no scenario she can imagine that would make expansion an affordable option for Maine.
“No matter the compromise, no matter the scenario, it will cost this state money to expand the Medicaid program and add tens of thousands, over 100,000 new individuals, to the program. Money that we can’t afford, knowing these other pressing priorities for these families.”
This is a debate that will likely wind down to the closing days of the session.