September 12, 2013

Mainers fall into Medicaid loophole

Failure to expand MaineCare leaves 10,500 people without coverage and ineligible for federal subsidies.

By Joe Lawlor
Staff Writer

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"It's very inexpensive and may be a very good alternative," Sanderson said, describing the exchanges.

Gagne-Holmes argued the opposite, pointing out that even though subsidized premiums may be low, the premiums combined with maximum out-of-pocket costs permitted under the law would mean that some low-income families would be spending up to 25 percent of their income on health care.

"If you're making under $15,000 and have to pay 20 percent of your income on health insurance, that's just not realistic," Gagne-Holmes said.

But J. Scott Moody, CEO of the Maine Heritage Policy Center, a conservative-leaning think tank, said Medicaid expansions in Maine have been proven not to work, and that they merely shift costs.

"The benefits of Medicaid expansion don't ever materialize," Moody said. "There has not been a decrease in the percentage of people uninsured in Maine even though we've had two expansions."

Moody said the expansions also end up increasing the cost of private insurance. For instance, young childless adults in low-paying jobs who qualify for MaineCare would in many cases choose free MaineCare over more costly coverage provided by their employer, he said.

That decreases the number of young people in the private insurance pool, making private insurance more costly for everyone, Moody said.

But Gagne-Holmes said in most of those situations, the young people end up being uninsured rather than accepting their employer's insurance, if MaineCare is not available.

Hilary Schneider, an official with Maine's American Cancer Society Cancer Action Network, said kicking people off MaineCare will result in more bankruptcies for individuals who end up with cancer. She said if they lose their jobs and health insurance because of the cancer and don't yet qualify for Medicare, they often end up with impossible-to-pay medical bills. Or they may end up not being able to afford chemotherapy treatments.

"It's going to be a huge undue hardship on people," Schneider said.

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

Twitter: @joelawlorph


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