Sunday, April 20, 2014
Gov. Paul LePage has gone a long way to divide Mainers in his zeal to block a federally funded expansion of MaineCare that would provide health coverage to as many as 70,000 people.
He first drummed up resentment by trashing the program, calling it “medical welfare” that steals resources from education, public safety and other government programs. Then he trashed its potential recipients, sneering that they are “able-bodied” adults who would take assistance that they don’t need and force “truly needy” Mainers to go without.
Perhaps his lowest blow, however, is his constant invocation of the thousands of elderly and disabled Mainers whose names appear on Department of Health and Human Services waiting lists. As long as those waiting lists exist, the governor says with great emotion, he would never consider expanding MaineCare any further.DIVIDE-AND-CONQUER TACTICS
The governor may look compassionate when he does this, but exploiting the plight of one group of unfortunate Mainers to create animosity against another is the opposite of compassion.
Instead, this is a rhetorical trick that ignores two important facts:
• The governor has never done anything to eliminate DHHS waiting lists even though he has had the power to do so for 3½ years.
• Refusing federal funds to cover working poor adults under the Affordable Care Act would not make those waiting lists a single name shorter.
The governor is using the people whose names appear on waiting lists as a means to advance his ideological agenda, not to help them get the services they are waiting for. The governor and his allies should stop playing this cynical game and address the real issues regarding health care in Maine.
The waiting lists often are invoked but rarely explained. All of the names on the lists are of people who are currently enrolled in MaineCare for health care services. What they are waiting for are additional services from programs for which they are eligible. Those services vary widely.
According to figures provided by the DHHS to its research consultant, the Alexander Group, 3,910 people were on DHHS waiting lists last November. About two-thirds of them (2,509) were senior citizens waiting to be included in several home-care programs. These are worthwhile, valuable programs that should be expanded, but they are entirely state-funded and are not even part of MaineCare. They do not belong in the MaineCare expansion discussion.
The second group of programs involve, for the most part, people with developmental disabilities who are eligible for home-based or community-based services. Some people are on more than one list, so it is difficult to pinpoint the exact number of individuals, but it was about 1,400 last year. Although there are fewer people in the second group than in the first group, their care is much more expensive.
The state could wipe out the first group of waiting lists, cutting total number of affected people by two-thirds, if it spent about $9 million. It would cost about $39 million of state money to clear the second group of lists, even though those involve programs in which the federal government pays most of the cost.
It is the $48 million price tag — not the possible addition of now-uninsured adults to the MaineCare rolls — that keeps people waiting for space in these programs. If LePage really thought that those programs should be expanded, he could have done so long ago.IT’S UP TO DHHS, LEPAGE TO ACT
LePage has introduced two full budgets and supplemental budgets since taking office in 2011. None of them included money to fix the problem. The governor barely mentioned the lists until last June, and that was when he was using them as an excuse for fighting MaineCare expansion — as if there were any connection.
Still, when the governor, a member of his administration or an ally in the Legislature talks about the issue, they usually say that it would be cruel to expand MaineCare for Mainers with low incomes and no insurance as long as these waiting lists exist.
It is time to retire this talking point. Until the people in charge of the DHHS propose a way to speed up their own process, they ought to stop complaining about how slow the process is.
Elderly people and people with disabilities don’t deserve to be used as political weapons against the friends, neighbors or, in some cases, members of their own households who would benefit from MaineCare expansion.
If the governor wants to fight an ideological battle about which of the poor are “truly needy” and which are undeserving, that’s his business. But he should leave the people on the waiting lists out of it.
Maine needs leaders who bring people together, not ones who drive them apart.