Misleading on Medicaid hurts real Maine people

As fall looms in Maine and another election campaign gears up, misinformation about Medicaid is proliferating. Unfortunately, before Maine people decide in November whether to join most states in expanding the program, it will probably get even worse.

Promoting alternative facts is a real shame because we deserve an honest debate about a policy that would do much good. As Consumer Reports notes, Medicaid is “good insurance.”

Over 70,000 working low-income Mainers would gain health insurance through Medicaid expansion. Some have health issues they don’t even know about that hurt their ability to live long, productive lives. Others already have chronic conditions like high blood pressure or lupus, or are addicted to opioids. Some could develop a critical condition and need expensive emergency care.

Expansion would help them, their families and their loved ones. Medicaid expansion would also support rural hospitals, keeping them strong for everyone nearby.

A woman holds a sign at a January 2014 State House rally for Medicaid expansion. Troy R. Bennett | BDN

Meanwhile, the sheer range of types of Medicaid misinformation is impressive in its own way.  Medicaid misinformers sometimes say things that are blatantly false while others operate by leaving out key information or context. Some misinform about the bill passed by U.S. House Republicans, others on what happened in Maine in the past, and still others on the impacts of Medicaid expansion around the country.

First, take the flat out falsehoods from Rep. Bruce Poliquin, who claimed to a closed-door meeting of donors, that the repeal and replace bill he voted for didn’t cut Medicaid.

In reality, Poliquin voted for spending a whopping $834 billion less for Medicaid over a 10-year period compared to current policy. Poliquin also voted to cap how much funding states would get. Despite his denials, both would have had huge effects.

The facts can be seen in cold, hard numbers in Table 4 on page 40 of the Congressional Budget Office report on the House bill, which shows that 14 million would lose coverage due to Medicaid cuts.

As Sen. Susan Collins put it, the GOP plans would have imposed “fundamental sweeping changes in the Medicaid program and those include very deep cuts. That would affect some of the most vulnerable in our society, including disabled children, poor seniors. It would affect our rural hospitals and nursing homes, and they would have a very difficult time even staying in existence.”

While mischaracterizing Medicaid in private, Poliquin avoided questions from the public and the journalists who inform his constituents. At that fundraiser, Rep. Poliquin said answering questions from the media about his positions would provide “ammunition” that could cause him to lose reelection. Previously Poliquin put his anti-transparency strategy into action by ducking into a bathroom when asked questions about health policy.

Second, by omitting crucial national context, others have misled about what happened in Maine during an earlier expansion. Their complaint is that not enough Mainers gained coverage overall.

But before the adoption of the Affordable Care Act, American adults not old enough to get Medicare were losing coverage. Maine bucked the national trend, showing the state policy was a success. Research shows that more insurance back then led to fewer deaths, especially for illnesses that are relatively easily affected by health care, heart diseases, infections and cancer.

Third, although some claim Medicaid hasn’t helped much, all around the country Medicaid expansion states have better coverage, less financial stress, improvements in health, better prevention, more opioid addiction treatment, and stronger rural hospitals. According to research by Suzanne Mettler and Lawrence Jacobs, states that expanded Medicaid now have little difference between low-income and high-income people when it comes to insurance coverage. The non-Medicaid states still have big disparities.

Hit by lies that Medicaid expansion hurt disabled people on waiting lists, Republican Gov. John Kasich of Ohio asserted that was “false, as it is just the opposite of what actually happened.”

Misleading on Medicaid is probably happening because it’s so popular. A recent Kaiser Health Tracking poll found that a whopping 74 percent of Americans, including 76 percent of Independents and 61 percent of Republicans, saw Medicaid favorably.

Though the effort to convince Mainers that Medicaid expansion is a bad idea is in full swing, most people appreciate this long-standing, very effective health insurance program.

 

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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.