January 2, 2013

Maine Voices: Maine must remain on road of moderate spending, debt reduction

Now is not the time to abandon efforts to rein in welfare overruns and repay what's owed to hospitals.

By HEATHER SIROCKI Special to the Press Herald

SCARBOROUGH - While Washington is facing a "fiscal cliff," the Maine Legislature is dealing with its own financial woes. Maine's spending problem is in the form of welfare cost overruns and is not a surprise -- it is a regular occurrence.

This year Maine will spend an additional $100 million on the Department of Health and Human Services, Maine's welfare agency, than originally estimated, and each year the DHHS grows faster than projected. Maine also owes its 39 hospitals almost $500 million in unpaid Medicaid bills.

Some legislators will justify this news by saying Maine's budget estimates are never completely accurate.

It is impossible to accurately project any state budget to the penny, but the real issue is our continued and repeated over-spending. Even if this year's projections had been perfect, the fact remains that we're spending an extra $100 million on welfare and are morally and legally obligated to pay our hospitals the $500 million we owe them.

An important question to consider is, how did the state get into this predicament?

The federal government established Medicaid as a safety net for disabled individuals with low incomes. With good intentions, Maine's Medicaid program, which is called MaineCare and is administered by the DHHS, was expanded to cover far more people than originally intended and working Mainers are struggling to foot the bill. For example, MaineCare extends beyond the federal guidelines and other states' standards to cover young and able-bodied individuals.

Over the past 10 years, Maine's Medicaid enrollment ballooned by almost 80 percent, yet our population only grew by 7 percent.

Maine has three times the number of people on Medicaid as New Hampshire, a state with a similarly sized population. In fact, Maine has the third-highest per capita Medicaid enrollment in the nation and 50 percent more than either the New England or the national average.

Originally designed to serve a limited, needy population, MaineCare has evolved into a "Cadillac" mainstream health insurance program with no co-pay and broad services. Maine cannot afford it.

This is more than just numbers on a balance sheet; it is a matter of economic health. To pay our current and future obligations, some are again proposing to raise taxes. But according to one study, raising taxes to cover last year's $121 million DHHS shortfall would have cost the state more than 6,000 jobs.

And there are multiple reports of Maine hospitals eliminating jobs, implementing hiring and construction freezes, and cutting services due to lack of debt payments from the state.

Fortunately, we have begun tackling the problems of the DHHS' expansion and hospital debt. In the last term, we paid down $248 million worth of the state's debt to Maine hospitals, and meaningful structural reforms were enacted to help bring our health care costs in line with national averages.

For example, a two-year cap will replace the previously unlimited supply of methadone to drug addicts on MaineCare, saving taxpayers $1.3 million, and overall state welfare spending as a percentage of gross domestic product was reduced by 14 percent under Republican leadership.

But will the new Democratic legislative majority go back to overspending and ignoring debt obligations, or will they continue on the path of the past two years, finally bringing moderation to our spending, prioritizing our resources and paying down our debts?

I became concerned when I learned that the new House speaker, Rep. Mark Eves, expressed his belief that it is "morally wrong" to limit the growth of our welfare programs and implied that new proposals were somehow part of an "extreme ideological agenda." Now is the time for all ideas, even radically different ones, to be on the table.

It is morally wrong to make promises that cannot be kept, it is morally wrong not to pay our debts, it is morally wrong that Maine's waitlists of disabled individuals are lengthening, and it is morally wrong to keep able bodied people trapped in a lifetime of dependency. Now is not the time to revert to the same old tax-and-spend philosophy of yesteryear.

You can help us avert Maine's fiscal cliff. Call or email your state representative or senator if you support Maine's continuing on the just and sound path of prioritizing its limited resources, looking for creative solutions and paying its debts to local medical providers. Those of us in the Legislature are contacted by constituents less often that one would think, and we always listen. Your voice makes a difference.

State Rep. Heather Sirocki, R-Scarborough, is beginning her second term in the Maine Legislature, where she serves on the Health and Human Services Committee.

 

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