Politics

September 18, 2013

In crossfire on MaineCare, parties vie for political edge

At stake is access to government-funded health coverage for more than 60,000 low-income Mainers.

By Steve Mistler smistler@pressherald.com
State House Bureau

AUGUSTA — Democratic legislative leaders said Tuesday that they will try again to expand the state's MaineCare program, as the political rhetoric on the issue heats up.

On Monday, Gov. Paul LePage and other Republicans spoke out against expansion, saying it would cost taxpayers and benefit mostly younger men, smokers and people who are more likely to drink alcohol.

The dueling positions reflect how Democrats and Republicans are vying for the edge in a public opinion battle over MaineCare, the state's Medicaid program, that could influence the 2014 gubernatorial campaign and legislative races.

Details of the Democratic bill were not revealed during a news conference held at the State House by House Speaker Mark Eves, D-North Berwick, and Assistant Majority Leader Sen. Anne Haskell, D-Portland.

The measure is likely to meet the same fate as Democrats' two previous attempts to expand MaineCare through the federal Affordable Care Act -- a veto by LePage and fierce resistance from most Republicans.

At stake is access to government-funded health coverage for more than 60,000 Mainers. Coverage would be available to adults without children who earn under $15,856 a year. Under the proposed bill, eligibility would expire after three years, when federal reimbursements for the program are scheduled to decline from 100 percent to 90 percent, unless the Legislature takes additional action.

Eves said a poll commissioned by the National Education Association and shared with Democrats showed that Mainers support MaineCare expansion. He said momentum is building in the Legislature, where a bipartisan compromise bill fell just a few votes shy of enactment in the final days of the session earlier this year.

LePage, who is seeking re-election, used a recent University of Michigan study to bolster his stance against MaineCare expansion. Although the study was supportive of expansion, LePage cited selected findings that showed the beneficiaries would tend to be younger men, smokers and those who are more likely to drink.

"This expansion of welfare would provide services to a younger population, while depleting scarce resources that are critical to care for those who desperately need assistance," LePage said in a written release. "We must ensure our neediest Mainers, the elderly and disabled, are put at the front of the line."

Eves said the governor is "doubling down" on his veto of the MaineCare expansion bill in the last session, and his recent remarks show that he's "feeling the heat."

Haskell, the Democratic assistant majority leader, took exception to the governor's position that those who smoke or drink should be denied health insurance.

"I don't know why this governor thinks he can pick and choose who should receive health care," she said.

Rep. Kenneth Fredette, R-Newport, said in a prepared statement that expansion would be "a costly and unnecessary mistake."

"If we're 'feeling the heat' of anything, it's a state budget that has been spiraling out of control for years due to the Democrats' reckless expansion of Maine's welfare system," he said.

More than 15,000 low-income parents are expected to lose coverage in January, when changes to MaineCare take effect. An additional 10,500 adults with no dependent children and incomes less than $11,500 will lose coverage.

The 10,500 childless adults fall into a loophole in the Affordable Care Act that makes them ineligible for federal subsidies for private insurance even if they're not covered by Medicaid.

Democrats are hoping that the pending loss of MaineCare coverage for some Mainers will convince some Republican lawmakers to support the new proposal.

MaineCare is likely to be a campaign issue in 2014.

Democratic gubernatorial candidate Mike Michaud has referred to expansion several times, including at his campaign launch in August, when he criticized LePage for vetoing the compromise expansion bill, which would have extended coverage to 3,000 veterans, among others.

"I wish that (LePage) had fought half as hard for (veterans) as they have fought for us," Michaud said.

Independent gubernatorial candidate Eliot Cutler weighed in on the issue Tuesday, saying LePage distorted the Michigan study on Medicaid expansion.

"For the governor to call this welfare, and to take facts from the study published in the Annals of Family Medicine out of context to support this point, is an affront to our most needy citizens," Cutler said in a prepared statement.

Jim Melcher, a political science professor at the University of Maine in Farmington, said the MaineCare debate is a logical campaign issue. He said LePage's statement Monday clearly framed the governor's position and that of his base of supporters.

"He got to what I think is a sense among some conservatives that some people aren't worthy of getting government help with health care, (that) it's not a human right," Melcher said. "Democrats are coming at it as health care is a right, something provided to everybody.

"It's a very legitimate issue," Melcher said. "Campaign issues are ideally about how you value what government should do or how well it's doing it. (Medicaid expansion) offers a very clear choice."

In the background of the ideological debate rages a battle over the minutiae of messaging.

Democrats, in making their case for expansion, have steered clear of calling MaineCare "welfare," arguing that Republicans have made the term pejorative.

Meanwhile, Republican operatives such as Fredette's communications director, David Sorensen, are using "welfare" as often as possible.

In a recent media statement, Sorensen wrote that Democrats "don't want to be the party of expanding welfare. But that's what (Medicaid) is, and that's what they (Democrats) are."

On Tuesday, LePage's communications office sent a media statement that used "welfare" 14 times.

"We just paid a half-a-billion dollars in welfare debt to Maine's community hospitals, and now Democrats want to start racking up more welfare debt by expanding Medicaid to people who have other options for affordable health care," LePage said in the statement.

Medicaid expansion is already a campaign issue in states such as South Carolina and Virginia. In Ohio, advocates are trying to advance expansion through a ballot initiative.

Several Republican governors have agreed to expansion, but others, like LePage, remain opposed.

Correction: This has been updated to correct the income threshold for childless adults eligible for Medicaid coverage.

Steve Mistler can be contacted at 791-6345 or at:

smistler@pressherald.com

Twitter: @stevemistler

 

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