January 27, 2012

State cuts would hit Portland extra hard

Leaders and businesses say they would hurt the region's economy and shift costs onto taxpayers.

By Tom Bell tbell@mainetoday.com
Staff Writer

Portland's business and political leaders and its hospitals are warning that health care cuts proposed by Gov. Paul LePage would disproportionately affect Maine's largest city, hurt the region's economy and shift costs to local property taxpayers, hospitals and private insurers.

click image to enlarge

Portland Mayor Michael Brennan

"If the state walks away from their obligation, it means local communities are going to step in to fill those needs," said Portland Mayor Michael Brennan. "It's not fair and it's not right."

Business leaders are concerned about the loss of health care jobs, as well as higher health insurance premiums, that could result if hospitals pass on the cost of ballooning charity cases to private insurers, said Chris Hall of the Portland Regional Chamber.

"The impact of this budget on Portland could be huge, not just for the city but the whole region," Hall said.

He said the region's business leaders understand the fiscal pressures driving the proposed cuts, but are hoping the Legislature will craft a bipartisan solution that will mitigate the cuts as much as possible.

LePage has proposed closing a $221 million shortfall in the Maine Department of Health and Human Services primarily by overhauling MaineCare, the state's version of the federal Medicaid program, to bring it closer to what other states spend on public health benefits. His plan would drop 65,000 people from coverage by tightening eligibility requirements.

The plan -- which was endorsed last month by the Legislature's Health and Human Services Committee -- also proposes cutting $29.5 million from the Fund for a Healthy Maine, about half the program's budget. The program pays for disease prevention and health promotion programs, such as oral health care for low-income children; grants to schools to reduce tobacco use; immunizations for pregnant women, uninsured and under-insured adults; and child care subsidies and after-school programs.

Brennan said the cuts would hurt Portland and other cities that provide services to the poor. He said Portland would lose $2 million, half of which would come from cuts to the Fund for a Healthy Maine, which was established in 1999 to distribute Maine's annual tobacco settlement payments.

The city would be forced to either eliminate programs or increase fees and taxes to pay for them, Brennan writes in a letter he plans to send to LePage and the Maine Legislature.

"During a time when our ability to respond to increased demand is limited, the city, local health care providers, businesses and nonprofits will be put in the impossible position of trying to fill the holes torn in the fabric of the state's safety net," Brennan says in the letter.

City officials say the proposed elimination of MaineCare benefits for childless adults would likely force the city's Health Care for the Homeless Clinic to close. The Portland Street clinic in the past 12 months received nearly $700,000 in MaineCare reimbursements for primary care services.

City officials say the cuts would also financially squeeze the Portland Community Health Care Center on Park Avenue. A third of the clinic's revenue comes from MaineCare reimbursement.

Cuts would also result in:

The elimination of case management services for the homeless. Last year, the city received $250,000 in MaineCare reimbursement for services to help homeless people find permanent housing.

The elimination of nearly all revenues for the city's anti-tobacco and anti-obesity programs. The loss of nearly $600,000 a year would eliminate eight full-time jobs.

(Continued on page 2)

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