DHHS: Medicaid Expansion Initiative Bad for Maine
Ballot initiative to expand Medicaid spells disaster for Maine budget, health care system
AUGUSTA – The Maine Department of Health and Human Services (DHHS) on Thursday responded to an announcement by a welfare lobbying organization that it would pursue a ballot initiative to expand Medicaid under the Affordable Care Act (ACA). Medicaid expansion has been vetoed and sustained five times by Governor Paul R. LePage.
“For years, expanded Medicaid eligibility in Maine wreaked havoc on our state budget, causing annual budget shortfalls, a massive government debt to our hospitals, and waitlists for severely disabled Mainers,” said DHHS Commissioner Mary Mayhew. “A bloated Medicaid system means fewer resources for Maine’s neediest citizens—our elderly and disabled neighbors and friends—and for other important state priorities, such as transportation, law enforcement, economic development, and natural resources.”
Far from being “free money” as its advocates insist, DHHS has estimated that the state’s share of Medicaid expansion would be in excess of $400 million over five years. States that decided to expand under the ACA are facing crushing costs associated with over-enrollment and the federal government has denied many states’ attempts to mitigate these unexpected costs.
Just last week, for example, in a story entitled “Rising Cost of Medicaid Expansion is Unnerving Some States,” the Associated Press reported that “more than a dozen states that opted to expand Medicaid [have] seen enrollments and costs surge beyond their expectations. In a report to Congress over the summer, the federal Centers for Medicaid and Medicare Services (CMS) said the cost of expansion was $6,366 per person in 2015, about 49 percent higher than anticipated.”
Furthermore, CMS has consistently rejected efforts by expansion states to reign in program costs. Most recently, the agency turned down Ohio’s proposal to charge small premiums to childless able-bodied Medicaid members who earn income of greater than 100 percent of the federal poverty level. In its response to Ohio’s proposal, CMS expressed its concern—which has become standard—that charging “premiums would undermine access to coverage and affordability of care,” even though an enrollee’s contribution would be no more than the lesser of $8.25 per month or two percent of the enrollee’s income.
Importantly, Medicaid expansion in Maine would only expand coverage to able-bodied, 21-64 year old adults, most of them without dependents. It would not expand coverage to a single child, pregnant woman, disabled person, or senior—all of whom are already eligible for Medicaid or Medicare coverage within certain poverty thresholds.
“It is imperative that Mainers educate themselves about the effect Medicaid expansion would have on the state budget, taxation, other government services, and on our neediest citizens who would be left behind by this proposal,” added Commissioner Mayhew.