The passage of the Affordable Care Act was supposed to reduce the number of working-age adults without health insurance. But in Maine, according to recent research, the ranks of the uninsured haven’t diminished over the past few years. That doesn’t mean it’s the Affordable Care Act that’s not working.

To make a huge, positive difference in the lives of the thousands of Mainers who still lack coverage, legislators should pass the latest proposal before them to take full advantage of the federal program and expand Medicaid eligibility.

The report on uninsured rates in Maine was released Monday by the Maine Health Access Foundation. The number of Mainers enrolling in insurance plans under the ACA started strong in 2014 and continues to grow, reaching nearly 75,000 last year.

But the rate of uninsured Mainers has held steady since 2013 at about 15 percent, the nonprofit advocacy group concluded, based on an annual state survey of Mainers’ health habits. During the same period, the number of Mainers receiving Medicaid shrank as tighter standards were put in place.

Those most likely to be uninsured? Men, young adults, people without a high school diploma and residents of rural areas, the report found.

The downsides to lacking insurance? Compared to people with coverage, the uninsured are more likely to put off preventive care or skip it altogether. So when they do get treated, caring for them is more expensive and more complicated.

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The ACA’s solution? Providing states with funds to expand Medicaid eligibility. The U.S. government would pick up 100 percent of the tab through 2016, gradually reducing that to 90 percent by 2020.

Gov. LePage and most Republicans in Augusta have staunchly resisted expanding Medicaid eligibility, citing concerns that Maine will be left holding the bag after federal officials back out of the deal. But the argument that the federal share could be cut is based on “pure speculation,” concluded the fact-checking service PolitiFact. What’s more, opponents of expansion aren’t taking into account its benefits.

States with expanded Medicaid programs have a lower uninsured rate than others – and, according to the Robert Wood Johnson Foundation, have seen “substantially greater declines” in the tab for uncompensated hospital care.

Reinforcing these conclusions is new research out of the University of Michigan, which found a 50 percent drop in hospital stays by uninsured patients in expansion states – meaning that hospitals there have more to spend on research and improving the quality of care. (There’s been no such change elsewhere.)

Meanwhile, Tom Saviello of Wilton and Roger Katz of Augusta, the moderate Maine Republican state senators who are collaborating on another attempt at expanding Medicaid eligiblity here, note that it would help finance the growth of substance abuse treatment facilities that are desperately needed to address a raging heroin epidemic.

Medicaid expansion makes sense for both economic and humanitarian reasons, and legislators should channel their energy into reaching a compromise that will let them move ahead with the program. The well-being of people across Maine is at stake.


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