Wednesday, April 16, 2014
By Peggy Akers and Ann Woloson
PORTLAND — Veterans Day is a day of sales and speeches and parades, but truly a day to think of and remember Maine’s veterans – those serving and those who have served. Access to health care is an important part of all people’s lives, but for the 150,000 veterans living in Maine, it must be part of their “welcome home” and “thank you.”
Peggy Akers of Portland is a nurse practitioner and Vietnam veteran.
Ann Woloson works for Maine Equal Justice Partners in Augusta.
We can show our respect and appreciation by ensuring that all Maine veterans have access to the health care they need. Unfortunately, and contrary to popular belief, not all veterans are eligible for affordable services through the Veterans Affairs health care system. In fact, nationwide, one in 10 veterans is uninsured and does not use VA health care services. While many work, they often have low incomes and can’t afford health insurance coverage that would help them access and pay for the care they need.
A recent analysis of American Community Survey Data by the Urban Institute indicates that 1.3 million U.S. veterans are uninsured. The analysis confirms that uninsured veterans have substantial medical needs and a disproportionate number and complexity of health issues. Over 40 percent reported having unmet medical needs and a third of uninsured veterans have at least one chronic health condition. Over 15 percent have other health care conditions including physical, mental, or emotional health problems. Some are likely to ignore disease symptoms when they first appear and delay diagnosis and treatment because they can’t afford to see a health care provider.
The Urban Institute analysis estimates that about 535,000 uninsured veterans are eligible for comprehensive health coverage under the Affordable Care Act provision to expand Medicaid. Eligibility for this coverage, however, depends on each state’s decision to accept the federal funding that would help pay for health care services provided under expansion. It’s estimated that nearly 3,000 veterans in Maine would benefit from expansion if the state accepts the federal funds that have already been dedicated to our state to cover people with low income.
The ACA law requires the federal government to pay 100 percent of the cost of health care services provided during the first three years to people with low income (138 percent of the federal poverty level or about $15,857 gross income for an individual). The federal funds will decrease slowly after that, but never to less than 90%. States can opt out any time.
No one would debate how important the VA is in providing necessary health care to many of our veterans. Access to health care services through the VA, however, can be limited and unaffordable, especially for people with illness or chronic disease unrelated to their service. For the most part, family members are not eligible for health care through the VA, and its services are often difficult to access, especially for veterans living in rural areas where VA services are unavailable.
Expanding Medicaid (MaineCare) would provide access to health care services for nearly 69,500 Maine people, including veterans and family members who work in low-wage jobs who have limited income. It would improve access to preventive care and treatment for disease and chronic illness. Care continuity for veterans and family members in need of ongoing treatment would improve.
Given that Medicaid expansion would be mostly funded by the federal government and provide coverage to thousands of low-income people in Maine, the benefits of accepting federal funds to expand Medicaid couldn’t be more obvious. Expansion would fuel Maine’s economy. It would provide additional funding to our health care providers and hospitals and help preserve Maine’s health care safety net in rural areas of the state. It would provide more than $250 million in additional federal funding annually to Maine and create more than 3,100 jobs. Expansion would help decrease the amount of charity care that would need to be provided to people without insurance and slow private health insurance premium increases. Now we know expansion would help nearly 3,000 Maine veterans and another 1,000 family members access the health care they need and deserve.
Veterans Day and every day should be a day where veterans have easy and affordable access to the best health care. Accepting the federal funds to expand Medicaid would be a gift from all Mainers to our veterans.
— Special to the Press Herald