Portland’s business and political leaders and its hospitals are warning that health care cuts proposed by Gov. Paul LePage would disproportionately affect Maine’s largest city, hurt the region’s economy and shift costs to local property taxpayers, hospitals and private insurers.
“If the state walks away from their obligation, it means local communities are going to step in to fill those needs,” said Portland Mayor Michael Brennan. “It’s not fair and it’s not right.”
Business leaders are concerned about the loss of health care jobs, as well as higher health insurance premiums, that could result if hospitals pass on the cost of ballooning charity cases to private insurers, said Chris Hall of the Portland Regional Chamber.
“The impact of this budget on Portland could be huge, not just for the city but the whole region,” Hall said.
He said the region’s business leaders understand the fiscal pressures driving the proposed cuts, but are hoping the Legislature will craft a bipartisan solution that will mitigate the cuts as much as possible.
LePage has proposed closing a $221 million shortfall in the Maine Department of Health and Human Services primarily by overhauling MaineCare, the state’s version of the federal Medicaid program, to bring it closer to what other states spend on public health benefits. His plan would drop 65,000 people from coverage by tightening eligibility requirements.
The plan — which was endorsed last month by the Legislature’s Health and Human Services Committee — also proposes cutting $29.5 million from the Fund for a Healthy Maine, about half the program’s budget. The program pays for disease prevention and health promotion programs, such as oral health care for low-income children; grants to schools to reduce tobacco use; immunizations for pregnant women, uninsured and under-insured adults; and child care subsidies and after-school programs.
Brennan said the cuts would hurt Portland and other cities that provide services to the poor. He said Portland would lose $2 million, half of which would come from cuts to the Fund for a Healthy Maine, which was established in 1999 to distribute Maine’s annual tobacco settlement payments.
The city would be forced to either eliminate programs or increase fees and taxes to pay for them, Brennan writes in a letter he plans to send to LePage and the Maine Legislature.
“During a time when our ability to respond to increased demand is limited, the city, local health care providers, businesses and nonprofits will be put in the impossible position of trying to fill the holes torn in the fabric of the state’s safety net,” Brennan says in the letter.
City officials say the proposed elimination of MaineCare benefits for childless adults would likely force the city’s Health Care for the Homeless Clinic to close. The Portland Street clinic in the past 12 months received nearly $700,000 in MaineCare reimbursements for primary care services.
City officials say the cuts would also financially squeeze the Portland Community Health Care Center on Park Avenue. A third of the clinic’s revenue comes from MaineCare reimbursement.
Cuts would also result in:
• The elimination of case management services for the homeless. Last year, the city received $250,000 in MaineCare reimbursement for services to help homeless people find permanent housing.
• The elimination of nearly all revenues for the city’s anti-tobacco and anti-obesity programs. The loss of nearly $600,000 a year would eliminate eight full-time jobs.
• The elimination of $189,000 in funding used to support school-based health centers. City officials say that five of the six centers would be closed.
• The elimination of preventive teeth cleanings and sealants for low-income children in city schools.
• The reduction of $202,000 in annual funding for the city’s Home Visitation program, reducing the program’s services by 80 percent. The program sends nurses to families with newborns to promote child health, safety and development.
City officials say the elimination of a state program that helps the elderly buy medicine would force more seniors to apply for general assistance aid.
LePage’s proposals also would substantially reduce revenues at the city’s two hospitals, Mercy Hospital and Maine Medical Center.
At Mercy, the cuts would lower revenues by an estimated $6 million a year, said Eileen Skinner, president and chief executive officer. As a result, the hospital would likely close the Mercy Recovery Center, the largest substance-abuse treatment center in Maine. Closing the Westbrook facility, which serves people from all over the state, would eliminate 100 jobs.
Mercy supports the governor’s goal of being fiscally responsible, Skinner said. “But we obviously endorse an approach that is more gradual and targeted so things can adjust and people can understand the unintended consequences of whatever action they take,” she said.
The cuts would increase the number of poor people seeking charity care at the city hospitals, said Katie Fullam Harris, a lobbyist for MaineHealth, which operates Maine Med. Historically, she said, hospitals have turned to private health insurance companies to help subsidize charity care, a practice that increases the cost of private health insurance.
When asked about the proposed MaineCare cuts, LePage spokeswoman Adrienne Bennett said in an email that Maine can no longer afford to pay for an “overly generous” welfare program.
“The state is confronted with a $220 million shortfall within our welfare system and we can’t pay for it,” she said. “This proposal is not a slash-and-burn approach. What led us here were the unintended consequences of an expanding program that rolled off the tracks years ago.”
She said the governor is moving money from the Fund for a Healthy Maine to the Medicaid program in an effort to protect some of Maine’s most vulnerable.
Sen. Joe Brannigan, D-Portland, said state lawmakers must recognize that Portland provides services to poor people who come here from all over the state.
“People from other towns send them here,” he said. “We are geared up to help. We have the propensity to help. We don’t need the state to pull the rug from under us now.”
Staff Writer Tom Bell can be contacted at 791-6369 or at: