Some of the happiest people we know are folks who take great pleasure in “spoiling” their grandkids because they know they can count on parents to be rule-makers and limit-setters. Unfortunately, as a result of Maine’s opioid addiction crisis, others have been forced to take on primary parenting duties instead. That means being available 24-7 for arduous duties normally handled by moms and dads, and spending retirement savings on everything from diapers to groceries to babysitters if budgets allow.
This is just one of the outcomes of a medical problem that prevents too many parents from being able to be responsible for their kids. It’s also a public safety problem due to the large number of addicts who become involved in criminal activity. Nationwide, opioid addiction costs society an additional $1.5 billion in correctional facilities, $1.5 billion in police protection and $726 million in costs for the legal system to deal with people who have been arrested for committing crimes related to opioid use.
As a result of this, we’re both concerned about the fate of the Medicaid program — known as MaineCare here in our state, which pays for basic health insurance coverage for about 273,000 Mainers and for treatment for about three out of every 10 people who are trying to overcome opioid addiction nationwide. While the program isn’t perfect, it currently pays at least 64 percent of the cost of covering each person enrolled in MaineCare, and can be counted on by States in helping to address dire needs such as the opioid addiction crisis or health care costs that may arise from a natural disaster or other health care calamity.
This could change drastically if Congress passes legislation to create a “per-capita cap” structure for Medicaid. That would initially cap federal Medicaid funding to states based on the amount it spent on health care services provided to certain groups of people in 2016. While the cap would be adjusted over time, the Congressional Budget Office estimates it would be insufficient in future years, providing funding at a much lower than the actual need. The new structure would ultimately reduce the amount of federal Medicaid funding for Maine by $1 billion between 2019 and 2028.
For obvious reasons, these changes would make it much more difficult to deal with opioid addiction and would impact public safety. In response to funding shortfalls, Maine and other states would also have to raise taxes and/or cut budgets for other important priorities such as education while making difficult choices in determining which health care needs to cover.
Cuts in funding could be particularly bad for the four in 10 kids who, thanks to Medicaid, can currently see a doctor when they get hurt or sick. And for the six in 10 newborn children who receive care through MaineCare during the first year of their lives.
Residents of rural areas, who represent the highest percentages of people who rely on MaineCare, would also be at-risk, as would rural hospitals that already spend more than $30 million per year on uncompensated care. With fewer people covered by Medicaid, more will seek care in emergency rooms, which will raise the costs of uncompensated care even more, thereby threatening the ability of these hospitals to remain open.
Fortunately, the news isn’t all bad. Last year Congress did pass the 21st Century CURES Act, which provides $1 billion in grants to enable states to address opioid abuse. While this new funding is a welcome investment in the fight against addiction, its value would be greatly undercut if changes to Medicaid being considered by Congress are implemented causing thousands of Mainers to access to the health care they need.
As law enforcement professionals and members of Fight Crime: Invest in Kids, we want all young people to grow up to become productive adults who don’t become involved in crime. That is more likely to happen when parents are healthy and responsibly engaged in their kids’ lives. As lawmakers consider Medicaid reform proposals, we hope they recognize its true value in beating back addiction and fostering better health care for kids and families nationwide.
Joel Merry is the Sagadahoc County Sheriff. Michael Field is the Bath Chief of Police
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