What happened in Cleveland after Medicaid expansion shows Maine blew it

A doctor treating a patient. Creative Commons: World Bank Photo, 2013

A doctor treating a patient. Creative Commons: World Bank Photo, 2013

In Maine, Gov. LePage and Republican opponents of Medicaid expansion claimed that an expansion wouldn’t improve health outcomes nor decrease emergency room use.

But look what’s happened in Cleveland 

Cleveland taxpayers did a sort of early Medicaid expansion which involved a public hospital, MetroHealth.

Greater coverage was joined by intensive outreach and follow-up. The results were impressive.

The results from the first nine months are in, said Dr. Randy Cebul, a researcher at MetroHealth. . .

“The diabetes outcomes were probably the most impressive,” Cebul says. “The sugar control, the blood pressure control, the lipid control, virtually everything was much better and dramatically so.”

The hospital also assigns each patient a nurse. That nurse books their appointments, calls them if they miss one and checks to make sure they took their medications.

In nine months, emergency department visits dropped 60 percent and primary care visits went up 50 percent.

The hospital also ended up spending less than it budgeted, saving an average of $150 on each patient every month. [source]

Lives were changed as money was saved, making this a very successful policy.

Oregon, which has been pursuing a coordinated care model, is also seeing reduced emergency room use, lower costs and better results.

Oregon’s results include these specifics:

[H]ospitalizations for congestive heart failure fell by 27%, chronic-obstructive-pulmonary-disease-related hospitalizations dropped 32%, and adult asthma hospitalizations decreased 18% . . . [source]

Maine isn’t getting these advantages of more coverage and better, more focused and well-coordinated care. It isn’t improving heath and saving lives.

Not only was coverage not increased in Maine. Instead, due to Gov. LePage and most Republicans in the state legislature, thousands of Maine people lost coverage.

Not surprisingly, the Alexander Report never considered the human costs from heart attacks that could have been prevented. Nor did it include the financial outcomes of saving money by increasing coverage and improving health care.

So Maine taxpayers are out the money spent on that slipshod, plagiarized report, while the state doesn’t get what other places have: a well-done Medicaid expansion effort that helps our people and our hospitals.

There is nothing fiscally responsible about this poor policy decision.

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. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.