Maine’s continued rejection of Medicaid expansion is hurting not only thousands of uninsured Mainers, but also health care workers themselves – like the 22 people recently laid off from the Farmington-based Franklin Community Health Network – to help make up for revenue that the health system is losing because of the state’s failure to expand Medicaid.

Gov. LePage and his allies in the Legislature have repeatedly opposed expansion as a handout to “able-bodied” people who’d rather get government assistance than get a job. Now that they have evidence that their intransigence is affecting some of the state’s biggest employers, they should re-think their position and support expansion as a way to keep Maine’s health systems healthy.

Maine's rejection of Medicaid expansion has helped drive up charity care costs for hospitals in the state and put them at a disadvantage under federal law. Chris Bradshaw/Shutterstock.com

The layoffs at the Franklin health system – which runs Franklin Memorial Hospital in Farmington – are part of a cost-reduction plan that includes the elimination of 40 full-time positions. Chief Financial Officer Wayne Bennett explained in the Morning Sentinel this week how the failure to expand Medicaid has cost the system money.

For one thing, it’s caused a slight rise in the number of uninsured patients who need free care. For another, it’s driving up the number of people who don’t seek care at all, reducing the number of patients the system would see.

At Franklin and other Maine hospitals, Maine’s failure to broaden Medicaid is seen as a primary driver in soaring charity care costs, from over $100 million in 2000 to over $570 million in 2014.

Health care facilities are also losing out on Medicare revenue. That’s because the Affordable Care Act assumes that states will approve expansion, providing hospitals with more paying patients and reducing charity care expenses. This is supposed to protect the facilities from the costs of Medicare reimbursement cuts, which are also part of the law.

Operating under the ACA without Medicaid expansion is “clearly a factor (in) the financial hardships of hospitals,” Maine Hospital Association lobbyist Jeff Austin told the Sentinel, noting that about 40 percent of hospitals in Maine are currently operating at a deficit.

Health care facilities in other states that didn’t expand Medicaid – such as Georgia, Oklahoma and Tennessee – have also had to lay off staff or even close their doors. This is what happens when lawmakers decide health-related issues purely on their political merits.

Maine state Sen. Tom Saviello, a Republican whose district includes the Farmington area, sponsored expansion legislation this session, but it never made it to a vote. He plans to reintroduce the bill next session – which should give expansion’s critics in Augusta time to study the mounting evidence against their stance and come down on the side of what’s best for their constituents and those who care for them.

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