While most states are deciding whether to expand Medicaid or whether it was a good idea to have already done so, Maine stands out by continuing to offer health care to the poorest citizens while paring back the state’s risk of future financial meltdown caused by unsustainable enrollment growth.
Key to the reforms is reduced eligibility for MaineCare, as Medicaid is known in the state, eliminating from the rolls many of those who are able to receive subsidies for coverage through the federal health exchange established under the Affordable Care Act, or Obamacare.
Adrienne Bennett, press secretary for Gov.Paul LePage, explained, “Rather than expand welfare and burden taxpayers, the governor demands that the system first take care of Maine’s truly needy: children, elderly, disabled, those with mental illness and who are still waiting for services.”
High Medicaid Enrollment
LePage’s cuts came after years of expansions by the previous governor resulted in more Mainers being enrolled in Medicaid as a percentage of the population than any other state, with nearly one in four signed up for a program intended for the neediest.
Former governor John Baldacci expanded MaineCare to adults without children in October of 2002 as part of the state’s Dirigo Health initiative, a failed attempt at achieving universal or at least near-universal health care access. Previously, Gov. Angus King had also expanded MaineCare eligibility.
Even after the cuts, Maine’s Medicaid eligibility is still extremely generous compared to many other states. Still eligible are children living in families with incomes up 157 percent of the federal poverty level (FPL); pregnant women with household incomes up to 209 percent of FPL; and young adults age 19 and 20 year who earn up to 156 percent of FPL.
Joel Allumbaugh, director of the Center for Health Reform Initiatives at the Maine Heritage Policy Center, noted the cuts focus help on the truly needy. “Prior expansions have extended benefits to able-bodied adults who have consumed resources that would otherwise be allocated to more vulnerable populations as evidenced by the waiting list of over 3,000 disabled and elderly citizens needing services,” he said.
Alexander Anton ([email protected]) writes from Chicago, Illinois.