Responsible Solutions Require an Honest Assessment of the Facts

It’s about income.

Maine Equal Justice Partners recently released a critical report that tells the true story about MaineCare’s Childless Adult Waiver Program.  Media coverage was extensive, but failed to include any critical assessment of the claims made by the report’s naysayer.

The Maine Heritage Policy Center’s (MHPC) Lance Dutson made the most audacious claim that the current policy of providing health insurance to childless adults making less than $10,890 a year hurts the private insurance market. Dutson told Maine Public Radio that “when people are able-bodied, young people that are being pulled out of the private insurance market, I think that’s a group of people we have to look at.”

Dutson’s assertion assumes two things, both of which are false.  63%of the low-income adults covered by this program are 35 or older and 43% are 45 or older.  MEJP also cites DHHS analysis that found 47 percent of program participants fell into a major diagnosis grouping of cancer or disease; 24 percent had a diagnosis categorized as a mental disorder, and 11 percent were treated for an injury or poisoning– hardly the young and able-bodied population that Dutson suggests. In fact, if these individuals showed up in the private insurance market, rather than decrease the costs of insurance for everyone else rates would likely increase because of the level of services they would require.  If they had no insurance at all, the cost for care they receive would shift to health care providers in the form of uncompensated care, to local communities in the form of increased requests for general assistance and to the premiums of the insured when providers raise their rates to compensate. Shifting costs is merely a shell game which none of us wins.

This raises a critical question.  How can anyone with an income of less than $11,000 per year, even if they are young and able-bodied, ever afford meaningful private insurance coverage in the first place?

MHPC’s ideologically inspired vision of a perfectly competitive private insurance market that would dramatically increase access to care for all people is a fantasy particularly if people don’t earn enough to pay for coverage.  Suggesting that providing MaineCare coverage to low-income childless adults somehow hurts the private insurance market doesn’t even pass the straight face test.

The world is not flat and it is time we challenge the statements of those who would suggest otherwise.  When credible evidence is available to refute such claims failing to hold the critics accountable is irresponsible.