Beyond Maine’s borders, some Republican governors have decided to expand Medicaid and several others, including in some very conservative states, are actively considering it.
Why are these Republicans taking this step?
One, it’s good for their people. Republican Gov. Jan Brewer of Arizona, a conservative known for some tense moments on a tarmac with President Obama, refers to Medicaid expansion as “pro-life.”
Indeed, research demonstrates that not having insurance is a major health risk. In an analysis of numerous major studies, Prof. Joseph Feinglass of the Northwestern University Feinberg School of Medicine notes that the health risk from not having insurance is on par with being a smoker. Moreover, “If we counted ‘lack of health insurance’ in late middle age as a health risk, it would rank as the third leading cause of death behind heart disease and cancer.”
One prominent study included Maine’s last Medicaid expansion and concluded that a broader expansion would save tens of thousands of lives. As Feinglass notes, “For every 176 additional adults covered, the study concluded, one death per year can be prevented.” Such a policy truly is pro-life.
Second, expanding Medicaid is good for their states’ economies. It promotes economic growth and produces jobs.
Gov. John Kasich of Ohio likened expansion to an economic booster shot and, while he encountered resistance from some in his party, his state’s business community supported this move.
In fact, local chambers of commerce from Bangor to Boise support extending Medicaid to more citizens. In part, this is because a healthy citizenry makes for a better workforce. But there are other reasons why it’s good for business.
With an expansion, money flows into hospitals and other health care facilities, enabling them to stay financially healthy. They can keep people in jobs, hire more and expand their facilities. Not only are health care jobs affected but also construction jobs, plus all the jobs associated with people with these jobs spending money in their communities.
People who would get or be able to keep health coverage are fishermen, craftspeople, entrepreneurs, farmers and those working low-paying jobs.
Losing coverage because of Maine Gov. Paul LePage’s decision not to expand Medicaid is Pete Miller of Ellsworth, a prep cook at Pat’s Pizza. He has to take a prescription for a blood clotting issue but private insurance is unaffordable. Also affected is Gail MacLean, who boards horses at her stable in Gray. “Now I’m tip-toeing around the farm, hoping I don’t hurt myself,” she said. “My fear is that if something happens, I’ll lose what I’ve worked so hard for.”
Keeping Miller and MacLean healthy keeps them contributing to their communities as citizens and taxpayers. And the more vigorous economy from money going into the health care sector means that, without raising tax rates, revenues to state government flow in more quickly.
Republican governors who rejected expansion are taking another look. As Ray Scheppach, former executive director of the National Governors Association, said, they may change their minds and take the federal money because “the numbers are overwhelming in terms of the positive economic impacts.”
In contrast, Maine’s Medicaid opponents don’t tend to talk about either saving lives or growing our economy.
For instance, the study by Gary Alexander on the costs of Medicaid expansion simply omitted both. Alexander didn’t look at whether Maine’s public health programs could, while preserving life, also save money if more people had preventive care.
Although Alexander should have analyzed how this influx of federal money into Maine’s health care would ripple through the economy and create higher state revenues, he ignored this dynamic and instead assumed that poverty would rise by a third by 2020. Thus the study overstates the cost of Medicaid expansion. At a time when credible information is needed by Mainers, the report fell short.
While Republican governors in conservative states like Kansas, Wyoming and Utah considered expanding Medicaid, LePage hired an ideological consultant and hasn’t moved a whit.
Maine’s policy could get unstuck if a few more Republican legislators support the Democratic proposal and vote to expand and override a certain veto from LePage. Or moderate Republicans could work out a compromise with majority Democrats that brings sufficient numbers of other Republicans along. Either would save lives and create jobs and opportunity.