Monday, April 21, 2014
The LePage administration continues to push a MaineCare reduction plan that at best will result in a costly legal showdown, wasting state funds that could be better spent elsewhere. At worst this strategy will cost lives instead of just dollars.
How can Gov. Paul LePage justify cutting 27,000 Mainers off their health insurance knowing that will almost certainly result in some of them dying?
On Wednesday, Commissioner of Health and Human Services Mary Mayhew said the state would move forward with its plan to drop 27,000 people from the program, which will likely result in a lawsuit on behalf of low-income Mainers.
The cuts would undo an expansion of Medicaid, known here as MaineCare, required of all states by the Affordable Care Act. A study by a Harvard University researcher published in the New England Journal of Medicine last week showed significantly lower death rates in states like Maine that have already expanded their Medicaid programs along the lines of the new requirements of the ACA.
The researchers compared health statistics in Maine, New York and Arizona before and after their expansion of Medicaid, to four states that had not (Pennsylvania, New Mexico, Nevada and New Hampshire). It found that the states that had expanded Medicaid showed a higher rate of people with health insurance, higher rates of people who report their health to be good and a 21 percent reduction in costs driven by late diagnosis of an illness.
But the most startling finding was a 6 percent reduction in the death rate of people between the ages of 20 and 64 in the three expansion states.
That finding alone should be enough to make the administration rethink its strategy. Gov. LePage recently declared that medical rationing that he incorrectly said was a feature of the ACA was unacceptable because it could cause deaths. How can he justify cutting 27,000 Mainers off their health insurance knowing that will almost certainly result in some of them dying?
For the sake of those people, it is fortunate that dropping these people from the program appears to be a violation of the ACA. Attorney General William Schneider claims that the recent Supreme Court decision that upheld the health care reform gives states some room to maneuver, but Maine should expect to fight that in the courts.
The question Mainers should be asking is whether such a fight is worth it -- even if it were successful. There is now evidence that insuring more people avoids costs and saves lives. The state could build on that and design a more efficient, less costly system that still gave people the care that they need.
The LePage administration and legislative Republicans passed these cuts knowing that they would have an expensive fight on their hands before realize any of the "savings." They should now ask themselves whether such a fight is worth winning.