February 22, 2012

Maine Medicaid costs above U.S. average

The Associated Press

PORTLAND — In his relentless demands for steep Medicaid cuts, Gov. Paul LePage has said Maine spends far more per capita than other states on Medicaid and is high above the national average.

Whether you support or oppose LePage's cost-cutting proposals, he's right.

Maine had the nation's fifth-highest Medicaid coverage rate in fiscal year 2009, 27.8 percent, behind California, New Mexico, Louisiana and Vermont, according to the latest statistics for Maine from the Centers for Medicare and Medicaid Services. The national rate for the same period was 21 percent.

Maine's Medicaid expenses for that year amounted to $1,890 per resident. That's 61 percent higher than the national average of $1,173 per person, according to CMMS statistics.

LePage and others say those numbers show that Medicaid, which goes by the name MaineCare in Maine, is bloated and in need of slashing. If Maine's enrollment were at the national 21 percent rate, the state would have had about 276,000 people enrolled, 90,000 fewer than actually were.

"I ask all of you, where is the outrage?" LePage said in a recent letter to legislators. "Maine Medicaid programs have grown at an unsustainable rate, and spending is out of control."

Medicaid is a federal program administered by the states that serves as the country's primary health insurance program for low-income Americans. More than 66 million people were on Medicaid in 2010 at a cost of about $384 billion. About two-thirds of the costs were paid by the federal government, and one-third by the states.

LePage has proposed cutting $221 million in Medicaid spending in Maine to reduce a budget shortfall through mid-2013 and bring Maine closer in line to national averages on Medicaid funding and coverage rates.

The Legislature's budget committee has endorsed a proposal calling for $120 million in cuts to the budget, nearly all in MaineCare, for the current fiscal year that ends June 30 and addressing the rest of the shortfall later. Lawmakers are expected to give their approval to the budget this week after the proposal stalled in the Senate last week.

The governor, for his part, says while Medicaid coverage is helpful to those in need, the state simply can't afford the broad coverage it now offers.

Medicaid coverage and costs have grown fast in the past 15 years in Maine.

About 202,000 Mainers had Medicaid coverage in July 2002. By October 2011, that number had grown to more than 361,000 residents, according to the state Department of Health and Human Services.

But the growth didn't just happen willy-nilly — it was the result of deliberate steps by legislators aiming to increase health coverage for children, parents, the elderly and single poor people in hopes of creating a healthier state.

Expanded Medicaid coverage is one reason the state went from No. 16 a decade ago to No. 8 last year in the United Health Foundation's annual state-by-state health rankings, said Chris Hastedt, public policy director at the Maine Equal Justice Partners organization. It's also contributed to Maine having an uninsured rate of 10 percent, the sixth-lowest in the country in the Kaiser Family Foundation's annual ratings, she said.

"It was a very deliberate set of actions aimed at very specific goals," she said. "To a very large extent we've achieved those goals with important success for people who've been covered and for the people of Maine."

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