September 17, 2013

LePage: Study backs no broader Medicaid

However, two health care experts say the same study makes the case for expanding the program.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

AUGUSTA – Gov. Paul LePage on Monday touted a recent University of Michigan study as bolstering his stand against expanding Medicaid in Maine.

Two health care experts, on the other hand, said the same study actually does the opposite and makes the case for broadening the health insurance program for low-income residents.

"Overall, the study reached different conclusions than the (LePage) press release highlighted," said Mitchell Stein, public policy director for the Maine advocacy group Consumers for Affordable Health Care.

Erika Ziller, a senior research associate at the University of Southern Maine, concluded that the study instead supports expansion efforts.

LePage this year joined other Republican governors in resisting Medicaid expansion, a key component of President Obama's Affordable Care Act. He vetoed an expansion of MaineCare -- as Medicaid is called in Maine -- this spring, effectively denying coverage to more than 70,000 uninsured Maine residents, although the issue will likely come up again when the Legislature reconvenes in January.

LePage, in a news release Monday, pointed out that younger men, smokers and those more likely to drink alcohol would benefit from Medicaid expansion, according to a study by University of Michigan researchers published in the October edition of the Annals of Family Medicine.

"This study illustrates why we oppose a very costly Medicaid expansion," LePage wrote of the study. "This expansion of welfare would provide services to a younger population, while depleting scarce resources that are critical to care for those who desperately need assistance. We must ensure our neediest Mainers, the elderly and disabled, are put at the front of the line."

But under the Affordable Care Act, Medicaid expansion dollars would not be directed toward seniors, so LePage gives an apples-to-oranges comparison, Ziller said. "A 35-year-old carpenter is not going to be taking the place of an elderly person at an assisted living facility," she said.

While new Medicaid enrollees under the federal expansion rules would be more likely to drink and smoke, the study also says that the expanded Medicaid population would include people who are less likely to be obese or have depression. Taken as a whole, the new enrollees would be healthier than current Medicaid recipients, according to the study.

"Overall, potentially eligible adults report significantly better health status than current beneficiaries," the study says.

With a healthier pool of people insured, the per-person costs of Medicaid should go down under expansion, according to Stein. And, he said, if the smokers and drinkers had access to health care, they would likely improve their health, which would also drive down health care costs.

"This would get them access into smoking cessation programs and into substance abuse programs where they could control their problems," Stein said.

The federal government would have reimbursed Maine 100 percent of the costs of the expansion for the first three years, and 90 percent in subsequent years. LePage pointed to increasing costs in future years as a reason to oppose Medicaid expansion.

According to LePage's news release Monday, "The (U.S.) Congressional Budget Office projects that 13 million people will become newly eligible for Medicaid in the states that choose to expand by 2022. The nonprofit Kaiser Family Foundation calculates this would cost states $8 billion more between now and 2022."

But the Kaiser Family Foundation website goes on to point out that while states would be paying $8 billion more for Medicaid through 2022, those states would also see their costs for uncompensated care -- which includes low-income residents being treated at emergency rooms -- go down.

"Combining this state and local savings with the expansion's $8 billion increase in total state Medicaid costs, we find the expansion would generate $10 billion in net state savings from 2013-2022," said the November 2012 research on the Kaiser Family Foundation's website.

Even without factoring in savings for uncompensated care, Maine is one of a handful of states that would save money through 2022 by hooking on to Medicaid expansion, Democratic leaders in the State House said Monday.

"Estimates from the non-partisan Kaiser Foundation and the conservative Heritage Foundation show that Maine will save $690 million to cover nearly 70,000 Maine people over the course of a decade," said a news release issued by the office of House Speaker Mark Eves, D-North Berwick.

Eves slammed LePage in the news release.

"Gov. LePage is spreading misinformation about a bill that would make it easier for more Maine families to see a family doctor when they are sick," Eves said. "We are talking about tens of thousands of hardworking Mainers who work as cashiers at our grocery and hardware stores, who care for our seniors, and nearly 3,000 veterans who served our country. These are the Maine people who will benefit from health care expansion."

LePage argued that not expanding Medicaid would keep the system financially solvent.

"We have to make sure our safety net is protected," LePage said. "The rates we pay providers need to be sufficient to ensure that individuals on the program can get access to care. We have to address the challenges with the system to take care of those on the program now, before we can consider expanding to new members."

Joe Lawlor can be contacted at 791-6376 or at:

jlawlor@pressherald.com

Twitter: @joelawlorph

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