Saturday, March 8, 2014
Gov. LePage has made paying Maine's debt to hospitals his top policy priority. He says that paying for services already rendered is not only the right thing to do, it would be good for the state's economy.
A Democratic proposal linking repayment of Maine’s hospital debt to an expansion of Medicaid would be a good deal for the state, and the governor’s opposition to it is puzzling.
Raising $186 million in state money through the revenue of liquor sales would release $298 million from the federal government. Since hospitals are among the state's biggest employers and economic actors, these funds would reverberate through communities still struggling to recover from the recession.
He's right, but the same arguments can be made for another health care policy that he has chosen to oppose -- accepting federal funds to enroll more people in MaineCare, the state's version of Medicaid.
Expanding access to health care is the right thing to do: People with health insurance live longer and lead healthier lives than those without. And with 69,000 more Mainers insured -- all on the federal government's tab -- millions more dollars would be delivered to Maine hospitals and have the same positive effect on local economies.
And expanding Medicaid would attack one of the biggest cost drivers in Maine's high health insurance costs -- uncompensated charity care, usually in emergency departments.
Speaker of the House Mark Eves and Senate President Justin Alfond have offered LePage a deal that makes a lot of sense. They would bring LePage's plan to pay off the hospitals through the Democratic-controlled House and Senate if the governor would sign off on the Medicaid expansion.
But instead of seizing this as a bipartisan meeting of the minds, LePage has retreated to a familiar position, telling the Lewiston Sun Journal that Eves' and Alfond's behavior was "a sin" and "absolutely criminal."
LePage also charged, as he has in the past, that an earlier Medicaid expansion created the hospital debt the state is now struggling to pay off. But that's not the whole story.
Maine's debt to its hospitals was accumulating long before Medicaid was expanded because of a payment system that did not keep up with current expenditures. But even if LePage were right, this expansion is different because of the way the costs are shared.
Maine had to pay 40 percent of the program's costs under the old law, but under the Affordable Care Act, 100 percent of premiums for newly eligible people would be paid by the federal government for two years, and then phased down to no less than 90 percent. For no more than 10 cents on the dollar, Maine would get the benefit of having fewer uninsured people, less pressure on hospital charity care and economically healthy hospitals.
Why the Democrats should have to use leverage to get LePage to accept a deal this good for Maine is a mystery. His ideological opposition to the Affordable Care Act may be why he's continuing to hold out, but ideology was not enough to stop tea party Republican governors in Arizona, Florida and Ohio from advocating for their states to accept the funds.
All the elements of a good compromise are in the Democrats' offer. The governor should take it and move on to other matters.