LePage, Medicaid expansion foes should support this alternative

Credit: 401(K)2013/Creative Commons.

Credit: 401(K)2013/Creative Commons.

Opponents of Medicaid expansion in Maine are saying they don’t have a problem with the part of Obamacare that involves people getting subsidized insurance through the marketplace/exchange.

Truth be told, while these individuals have been quite critical of this element of the ACA, Gov. LePage mentioned it positively about a year ago.

More recently expansion foes point to it as an alternative to the proposal crafted by two moderate Republicans, while often not acknowledging that the poorest individuals without children would be left out in the cold. There will always be some people living under the poverty level and if Medicaid isn’t expanded, they won’t qualify for any subsidies.

Expansion opponents have even said that traditional Medicaid promotes dependence but subsidized insurance does not. I’m not clear how this logic works.

They also point to low reimbursement rates in the Medicaid program.

This should translate into supporting an alternative that involves private insurance and would cover people under the poverty level.

It’s an approach often called the “private option.”

Arkansas created it for their Medicaid expansion and New Hampshire plans on using it starting it 2016.

Looking to our New England neighbor, as the Concord Monitor reports:

This bill would give new premium subsidies to about 12,000 people with employer-based health plans. An estimated 45,000 additional people would get federal money to help them buy plans on the state’s insurance marketplace.

Senate President Jeb Bradley, a Republican, a cosponsor of the proposal, argues there’s much to like.

Putting more people on health insurance plans will decrease uncompensated care payments that drive up everyone’s health care costs, [Bradley] said. This plan also likely would bring the Medicaid managed care providers onto the exchange, creating more competition. (The state cannot get a waiver with only one provider on the exchange.) The bill also includes “personal responsibility measures,” like requiring eligible unemployed adults to seek help securing employment.

The bill also seeks a waiver to get more money from the federal government on Medicaid services not already being reimbursed, such as substance abuse treatment or care for the incarcerated. To get the waiver, New Hampshire must show it’s pushing the trend of drug usage down. This extra money would also help complement the state’s mental health care system, Bradley said.

If New Hampshire’s Republican-controlled Senate and Arkansas, a rather conservative state, can move in this direction, why can’t Maine’s Medicaid foes?

Based on what they’ve said about subsidized insurance, this should have their support.

The private option would help Maine people’s health and economic growth.

While some expansion foes claim that there’s no proof that Medicaid (and other insurance) saves lives, but even a study they tout shows otherwise. So leaving out the poorest will clearly lead to Mainers dying who wouldn’t have otherwise.

And, as Maine continues to struggle with nearly the lowest job growth in the nation, Medicaid expansion is a pro-growth policy. More than 4000 jobs and half a billion dollars in the state’s gross domestic product are at stake.

Jobs and health coverage are especially needed in rural Maine.

As the Maine Center for Economic Policy points out, “Maine’s employment recovery is confined to Maine’s three major cities and their immediate surroundings.”

At the same time, rural hospitals are hurting and would benefit greatly from Medicaid expansion, however it’s done. Rural Maine also has the highest percentage of uninsured individuals.

Most Maine people and legislators support expansion. Adopting the private option would be a clear compromise and would deal with many of expansion foes’ objections. Because most represent rural Maine, it would really help their communities and their constituents.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives.