MECEP’s analysis at the time cautioned lawmakers to consider the adverse consequences for older Mainers and those in rural areas, particularly small businesses.  We reached out to legislators on both sides of the aisle and offered to explain our analysis and the implications of this proposal for their constituents.  None of the bill’s proponents took us up on our offer.  They seemed unwilling to consider any information that might challenge their assumptions or the merits of this proposal.  They even refused to let the Bureau of Insurance comment on the proposal.

MECEP insists on credible research and analysis and found the rush to enact this rollback of Maine’s health insurance consumer protections very troubling.

Now, a new report (“The Impact of PL90 on Maine’s Health Insurance Markets”), commissioned by the Maine Bureau of Insurance as an independent analysis, has confirmed exactly what MECEP predicted.  Today, the Legislature’s Joint Standing Committee on Insurance and Financial Services is holding a hearing to consider the results of this study by Gorman Actuarial.

In anticipation, MECEP and our partners at Consumers for Affordable Health Care (CAHC)  prepared a comparison of what proponents of PL90 said about the law during the 2011 legislative deliberations and the conclusions of the new report to demonstrate that many claims by PL90’s supporters were mistaken.

The evidence clearly shows that PL90 gives too much power and profits to private insurance companies, undermines important consumer protections, and fails to address the issues that result in out-of-control health care costs.  It is a flawed law that the Governor and the Legislature must act to fix it.

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.

In a 12/28/2011 editorial, the Portsmouth Herald called the Administration’s plan “unsubstantiated, unfair, unthoughtful and possibly quite costly.”

In a 12/31/2011 Bangor Daily News op ed the leaders of three of Penobscot County’s most prominent community health care organizations wrote to “urge policymakers to analyze what the impact of 65,000 newly uninsured Mainers really means to our health care infrastructure and total health care costs, and only then make truly informed decisions regarding the MaineCare program.”

Richard A. Erb, President and CEO of the Maine Health Care Association, wrote in the 1/1/2012 (Lewiston) Sun Journal that “for some 4,000 assisted living residents and their families, Gov. Paul LePage’s supplemental budget proposal to completely eliminate part of Maine’s long-term-care system is cause for grave concern this holiday season.”

In the 1/2/2012 edition of the Kennebec Journal, former director of the Consumer Health Care Division of the Maine Bureau of Insurance Alice Knapp asserts “that health care is a basic human right and that access to health care is a moral issue.”  She cites an American Journal of Public Health
study finding that “every 12 minutes an American dies from lack of health insurance as the uninsured are more likely to go without needed care.”

MECEP and our partners in the Maine Can Do Better coalition of Maine progressive advocacy groups will continue to work to block the proposed cuts and provide reasonable alternatives.   Follow this blog, and MECEP’s Facebook and Twitter postings to keep up on our efforts.

Bangor Daily News

News

LePage’s proposed MaineCare cuts leave some reeling, others hopeful (12/8)

65,000 MaineCare recipients to lose health coverage under LePage plan (12/7)

Editorial

Safety net should be shrunk, not shredded (12/8)

Op Ed

Governor’s budget mismanagement will hurt poor and elderly (David Farmer) (12/8)

Portland Press Herald

News

LePage proposes dropping 65,000 Mainers off Medicaid (12/7)

Editorial

Our View: LePage’s MaineCare plan no way to cut costs (12/8)

Kennebec Journal

News

Chance for MaineCare overhaul may not last (12/8)

(Lewiston) Sun Journal

News

Battle lines drawn on LePage’s DHHS cuts (12/8)

Local agencies react to LePage plan (12/8)

‘It will have a real impact’: LePage announces sweeping changes to MaineCare (12/7)

Editorial

Region’s health should be asset to New England (12/7)

An evaluation of public benefits, private insurance (12/6)

MPBN 

Democrats: LePage Plan Will Shift Medicaid Costs to Private Insurance and Hospitals (12/8)

MaineCare Recipients Unsure Where to Turn as Coverage Loss Looms (12/8)

LePage Proposes Deep Cuts in Medicaid (12/7)

Advocates for Poor Decry LePage’s Proposed Medicaid Cuts (12/7)

WABI-TV
Governor Proposes Big Changes To Medicaid Amidst Budget Shortfall (12/7)

WCSH-TV/WLBZ-TV
LePage calls for Medicaid cuts to bridge gap (12/7)

Strimling & Harriman on Medicaid cuts (12/7)

WGME-TV

Organizations voice concerns about proposed DHHS budget cuts (12/8)

DHHS Proposed Cuts (12/7)

Portland Press Herald

Op Ed

Maine Voices: Programs for young children important to maintain (James H. Maier, M.D.)

(Brunswick) Times Record

Editorial

Best for business development

R&D investments pay dividends

Op Ed

GOP’s insurance plan is reckless (State Representatives Anne Graham and Alex Cornell du Houx)

‘Big dreams and vigorously pursued visions …’  (Tom Settlemire and Angela Twitchell)

Rail is poised for a revival (Doug Rooks)

Jane’s dad has been on dialysis for five years and is awaiting a kidney transplant.  Her mom was diagnosed with breast cancer and had a mastectomy this summer.  As if this wasn’t enough, doctors discovered that Jane (not her real name) had cancer while performing an appendectomy and removed the tumor during a subsequent surgery this fall.  Luckily at 21, Jane is as resilient as ever and has managed to keep pace with her studies.

Jane and her family have insurance.  Unfortunately, they could only afford a high deductible plan and Jane’s father, who is on Medicare, fell into the infamous “donut hole” – a place where despite being covered you’re on the hook for the cost of certain prescriptions.  Fortunately they live in a supportive community and Jane’s mom works for one of the most compassionate and community-minded businesses around, a locally owned grocery store.  Otherwise, it is hard to conceive of how she could have kept her job and maintained what health insurance she has during the many appointments (her own, her husband’s and her daughter’s) she has had to endure.

Stories like these are a reminder that those who wish to stonewall health reform and who claim that the free market and personal responsibility are the solutions to our health care woes are sorely mistaken and have long since lost sight of the human toll of our ideological machinations.

One bright spot from the world of health policy comes once again from Maine.  House Majority Whip Seth Berry has introduced a bill that would forbid coverage caps for health insurance.  This means that people with chronic or life-threatening maladies won’t be cut off from coverage when they need it most.  Already insurance companies have decried this proposal saying that it will boost premiums.  Of course, they’re not willing to say by how much.  In any given year, few people actually hit their cap and the incremental cost spread across all premium holders is likely minimal. 

MECEP is a proud member of a coalition that supports the proposal to forbid health insurance coverage caps.  The hearing for this proposal, L.D. 1620, is 1 p.m. on Wednesday, February 6.