I just came across what looks like a conspiracy to commit “welfare fraud” and I can’t wait to alert the ranking Republican in the Maine Legislature.
Oh, wait. It’s his idea.
“Making a conscious commitment to bring yourself above the poverty line allows you to receive these subsidies – with no penalty for falling short of that goal of improving your own economic future and working your way out of poverty,” wrote Senate Minority Leader Michael Thibodeau, R-Winterport, in a recent op-ed in the Kennebec Journal.
Translation: If you live below 100 percent of the federal poverty line and thus are ineligible for health-care subsidies under the Affordable Care Act, you need only nudge up your “projected” income for next year to just above the cutoff – and you’re in!
Asks Thibodeau, “Is it too much to ask of anyone receiving benefits to commit to improving their own economic future?”
Well, senator, if you’re suggesting that people deliberately lie about what they’ll make next year to sneak in under the federal health insurance umbrella, then yes, it is too much to ask.
In fact, it flies in the face of this statement at the bottom of the Affordable Care Act application (just above where the applicant affixes his or her signature): “I’m signing this application under penalty of perjury, which means I’ve provided true answers to all the questions on this form to the best of my knowledge. I know that I may be subject to penalties under federal law if I intentionally provide false or untrue information.”
Thibodeau’s winking and nodding is part of a broader strategy by Maine Republicans in recent weeks to use the Affordable Care Act (long the source of all evil in their world) as proof that there’s no need to expand Medicaid, known here as MaineCare, to about 70,000 low-income Mainers who now have no affordable access to health care.
Roughly half of those 70,000 folks have earnings between 100 percent and 138 percent of the federal poverty line. That would make them eligible for Medicaid if they lived in a state with expanded coverage. In the absence of expanded Medicaid, they qualify for subsidies in the new federal health insurance marketplace.
Whether such private-sector coverage is actually attainable for that group, however, depends on how easily (or not) they can shoehorn the extra costs into their already bare-bones monthly budgets. The heavily subsidized premiums – as low as $5 per week – may sound attractive, but the out-of-pocket deductibles and co-pays can run well into the hundreds if not thousands of dollars.
Meanwhile, for the 36,000 or so Mainers below the poverty line – $11,490 per year for a single-person household – that federal marketplace is plainly and simply off limits.
Why? Because the Affordable Care Act assumes that those people simply can’t afford private insurance – with or without subsidies – and thus should be covered through expanded Medicaid programs.
Which brings us to the Catch-22: Maine is one of 21 states that have flat-out refused to expand Medicaid.
And try as our Democrat-controlled Legislature might to muster a veto-proof majority to change that, MaineCare expansion is fast morphing from a moral imperative into an election-year political bludgeon. (Note to Republican lawmakers laying down in front of MaineCare expansion: Come November, you might be surprised to find how many of your constituents think it was a really bad idea to thumb your noses at $1 million per day in federal health-care subsidies for the next three years.)
This latest move, though, is politics at its absolute worst. By now dangling the Affordable Care Act in front of the lowest-income Mainers, Thibodeau & Co. have turned the clinical (Who doesn’t need to see a doctor now and then?) into the cynical (Pay no attention to that perjury warning! You’re improving your economic future!).
Appearing Monday on the Maine Public Broadcasting Network’s “Maine Calling” program, Jake Grindle, a health services navigator for Western Maine Community Action in East Wilton, called Thibodeau’s op-ed “very concerning, very dangerous advice.”
“If you know that you make less than the federal poverty level and you intentionally provide false or misrepresenting information on that application, there are civil and criminal penalties,” said Grindle. “You sign that application under penalty of perjury. I can’t say strongly enough to people, ‘Don’t lie on your application.’ ”
Karen Turgeon, a program director for 211 Maine who oversees health insurance marketplace navigation for the Portland-based Opportunity Alliance, wholeheartedly agrees.
In fact, Turgeon said, if you vault yourself over the 100 percent poverty line based on wishful thinking alone, there’s a pretty good chance it will come back and bite you.
“The problem is that when people go to file their taxes, if they projected incorrectly, then they’re going to have to pay that money back,” said Turgeon. “If you’ve miscalculated what your income would be, then the subsidy that you’ve received is inaccurate and you would ultimately owe money.”
That might happen right away. According to Grindle, some people who claim they’ll be crossing the 100 percent poverty line for the first time will be asked, as the year goes on, to provide documentation that they’re keeping up with their projections.
Or it might come a few years down the road. While there’s plenty of online speculation that the feds will never catch up with (or crack down on) poor people who tell a white lie to get their foot in the door to a doctor’s office, Turgeon said it might take several years for the other shoe to drop.
Bottom line, Turgeon said, “We would not encourage somebody to fudge what their income is. Our goal is not to put people into a situation that could become an issue for them later.”
That brings us back to Thibodeau, who’d be screaming to high heaven about all those welfare cheats if this hare-brained scheme didn’t dovetail so nicely with his (and Gov. Paul LePage’s) anti-MaineCare mantra.
“Individuals who can ‘anticipate’ their incomes will exceed the federal poverty level are eligible for a subsidy through the exchanges based on their anticipated income,” wrote Thibodeau in an email on Tuesday. “Perhaps we as Republicans have more faith in our fellow citizens than Democrats have.”
Or perhaps they’re just playing the poor for suckers.
Bill Nemitz can be contacted at 791-6323 or at: