May 25, 2013

Maine Voices: Democrats' Medicaid expansion measure lacks foundation in fact

They should instead back a Republican plan to repay hospital debt now and put off action on MaineCare.

By REP. KEN FREDETTE

AUGUSTA - It's become a rarity in politics these days, but Maine lawmakers and Gov. LePage achieved it together. We forged a grand bargain, a bipartisan bill with virtually unanimous support that would do more to create jobs than any other initiative this year.

By February, we all agreed that we should pay the nearly $500 million in past-due Medicaid bills the state owes to hospitals.

We instituted a payment system to ensure that the debt would stop accumulating, but the bad debt on the hospitals' books has been causing them to lay off workers, freeze wages and benefits and halt construction projects and upgrades.

We even agreed on a way to get the bills paid. The governor's plan to issue a liquor revenue bond to pay off the debt garnered bipartisan support when the Legislature's nonpartisan budget office said it was the best deal for Maine, saving $30 million when compared to another proposal.

Getting this debt off our books would also allow us to issue voter-approved bonds to repair our transportation infrastructure and make improvements to the University of Maine System. Even earlier this week, Moody's, the bond rating agency, emphasized the importance of the state's paying its Medicaid debt.

In all, we were looking at an $800 million capital infusion to Maine's economy. All seemed to be signed, sealed and delivered.

But then, just a few weeks ago, Democrats decided that they wanted to expand the state's Medicaid program under Obamacare and, without debate, decided that the best way to get it passed was to attach it to the hospital debt bill like pork barrel.

They didn't even try to build consensus on Medicaid expansion. They simply crammed the two bills together and rammed them through the committee process, forcing lawmakers to vote on things they didn't even get a chance to read.

This is exactly the type of behavior that got a Republican elected to the U.S. Senate from Massachusetts in the wake of the contentious passage of Obamacare. It's exactly the type of behavior that should stay in Washington.

The combined bill passed on party lines, with one Democrat objecting despite his support of expansion, and the governor issued a veto that the Legislature will sustain.

Republicans never even said "no" to Medicaid expansion. In fact, Gov. LePage was and is actively negotiating it with the federal government.

But the deal that the Democrats put forward is a bad deal for Maine.

It's the federal government's first offer, and by moving it forward prematurely, Maine Democrats are impulsively paying sticker price for the car without negotiating or doing their research. Republicans have done their research.

Democrats say expansion is free for the first three years and over 10, we'll save money.

However, Maine's Department of Health and Human Services is telling us that the only guarantee about those three years is that we'll have to pay more than $10 million in administrative costs. Beyond the first three years, we're looking at a massive new entitlement program, costing Maine taxpayers $75 million per year by 2020.

We already have the third-largest Medicaid program in the country per capita, and it gives us massive shortfalls every year, making it harder and harder to balance the state budget.

Besides, Maine's last Medicaid expansion is the reason why we have the hospital debt in the first place.

Democrats are saying that we'll reduce emergency room usage, charity care and the uninsured population.

But multiple studies show that people use the ER as much or even more when they're on Medicaid as they do when they don't have insurance, charity care has tripled since the last time we expanded the program, and the number of uninsured Mainers has barely changed as many simply switched from private insurance to Medicaid.

Besides, how could we responsibly consider expanding medical welfare for young, able-bodied men when we have 3,100 elderly and disabled Mainers on waiting lists?

There are other ways. For example, those who stand to be covered will receive federally subsidized private health insurance policies through the Obamacare exchanges beginning next year at a cost to them of about $5 per week.

That is why I have proposed a study group to examine Medicaid expansion so that we can gather all the answers, removed from the partisan rancor of the legislative process and session.

I sincerely hope Democrats accept my compromise and agree to pass the hospital bill now with no strings attached so that we can put $800 million into Maine's economy and get people to work.

Rep. Ken Fredette of Newport is the Republican leader of the Maine House.

 

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