Wednesday, December 11, 2013
Don't look for winners in the recent decision by the Obama administration to refuse waivers for most of the proposed health care cuts passed by Maine Republicans last year. There were only losers.
Secretary of Health and Human Services Kathleen Sebilius ruled that Maine could drop coverage for about 13,000 Mainers, mostly parents whose incomes fall between 133 percent and 200 percent of poverty, or $30,657 and $46,100 annually.
And the state has been given permission to stop providing assistance paying for prescription drugs to senior citizens and people with disabilities.
But most of the proposed $20 million in savings were not permitted, meaning lawmakers will have to go back and balance the budget they passed last spring.
This decision hurts the people who are losing their health coverage most of all, but it also is a clear rejection of the LePage administration's idea of reform, which has been to cut health care costs by cutting people off care.
No one can celebrate since those savings will have to be found elsewhere in the state budget.
Anticipating a federal rejection of the proposed budget cuts, former Attorney General Bill Schneider said he would consider appealing the ruling in court. With Democrat Janet Mills sworn in this week as attorney general, that's not going to happen.
If any good can come of this, it would be ending the confrontational style the administration has employed with its budget proposals. As Rep. Linda Sanborn, D-Gorham, wrote in a Jan. 7 Maine Voices column, "the problems we face are too big for one party to solve on its own." ("MaineCare solutions shouldn't place biggest burden on the most needy").
The governor shouldn't keep blaming the Democrats for the out-of-control MaineCare budget. The same inflation has been mirrored in Medicare and private insurance rates, showing this is not a budget problem but a health care delivery problem.
Lowering MaineCare costs by raising eligibility just shifts costs to other parts of an already overstretched system.
A better approach would be to focus on payment reform, managed care, wellness programs and other reforms that would lower all health care costs, including the ones paid by the state. That would be a decision in which everyone is a winner.