Editor’s note: Will Neilson is a Democratic candidate for Maine House District 53, a seat currently held by Republican incumbent Jeffrey Pierce.

I read with interest Rep. Jeff Pierce’s response to my letter of March 28 purporting to refute my argument that expanding MaineCare would be a significant boost to the Maine economy. Virtually every sentence contains a half truth, falsehood or logical fallacy, the detailed refutation of which would exceed the limits of a reasonable reader’s interest and patience. So let’s stick to the big picture.

First off, Rep. Pierce condescends to offer a history lesson about Maine’s earlier expansion of MaineCare, from which he draws a series of questionable conclusions. The essential point here is that Rep. Pierce seems not to understand that Maine’s unilateral expansion of Medicaid eligibility in 2002 and 2003 is in no way analogous to its participation in a national expansion of Medicaid under the Affordable Care Act. In the first case, Maine paid the same share of the expanded cost as it was paying for the already covered population. Under the ACA it would have paid none of the expanded cost for the first four years of the program, and will never pay more than 10 percent. Granted this is complicated stuff, but the crucial point is that the money would have come from the federal treasury where its cost is spread across our entire country, not the state budget, which is the money that Mainers have to raise themselves. And going forward, the vast majority of that money still will come from the federal government.

Next, Rep. Pierce calls MaineCare expansion “free healthcare,” which it is not. It’s free health insurance — the healthcare for the newly-covered people is paid-for healthcare, paid by the federal taxes we already pay but from which we fail to receive this important benefit.

By contrast, when someone shows up at the emergency room without coverage, the hospital is required to provide it “free,” i.e. without getting paid. But there is no free lunch, and Maine citizens eventually get stuck with bill in the form of higher healthcare and health insurance costs because the federal payments have been refused!

Rep. Pierce lists five states where he implies there have been negative consequences from Medicaid expansion, but as he fails to understand the difference between federal dollars and state budget dollars in Maine, it is difficult to know whether he has confused a benefit for a detriment, as he does in our state. (Vermont, which is one of the states on the list, tried to establish its own single-payer system, which no other state has attempted and for which the ACA was not designed. Thus Vermont’s experience cannot be usefully compared to any other state’s experience.)

Rep. Pierce repeatedly talks about expanding MaineCare to “able-bodied” people as though this were something bad, apparently not realizing that the “able-bodied” are not consumers of medical care. It is when the able-bodied become disabled that they need insurance, and the rest of us are better off if they have it.

Rep. Pierce suggests that I prefer put “able-bodied 20 year olds” in line ahead of the elderly, revealing that he doesn’t realize 20 year olds and the elderly don’t get in the same line for health care — the elderly are covered by Medicare, the 20 year old by Medicaid. (I find my implied disdain for the elderly particularly misplaced in light of the 15-odd years I have worked as a founder and advisor of a volunteer program to keep isolated elders connected with their communities and aging in place, SEARCH Greater Bath, administered by Catholic Charities Maine).

Finally, Rep. Pierce is self-congratulatory about the lack of a deficit for DHHS, DOT and the Department of Education. I can only look at this week’s closure of Merry Meeting Behavioral Health Associates, last month’s closure of Coastal Trans, the crumbling roads, and increasing property taxes for education and wonder about how much crowing is appropriate.

Republican Senators Katz and Saviello have their eyes on the bottom line with their bill, LD 633. Whether you are conservative or liberal, MaineCare expansion will boost our economy, and LD 633 should be supported by legislators of both parties.

On one point I do agree with Rep. Pierce: everyone’s entitled to their opinion, but not their own facts. MaineCare expansion will bring federal money we’re already paying for with our federal taxes to our state, and lots of it. That’s a fact. That money will pay salaries, purchase capital equipment to improve the healthcare sector, and made sick people healthier, so they can work and get paid themselves. That’s also fact. You can argue about the details of what the cost, if any, will be to the state budget, but the failure to get that federal money into the Maine economy amounts to governmental negligence. That’s my opinion.

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Will Neilson lives in Arrowsic.