Maine Medical Association urges lawmakers to compromise on Medicaid expansion

Scott Thistle/Sun Journal

Amy Madden, at podium, a family medicine physician at the Belgrade Regional Health Center, speaks to reporters during a news conference at the State House on Thursday. Madden, chairwoman of the Maine Medical Association's Legislative Committee, urged lawmakers to reach a bipartisan compromise on expanding MaineCare, the state's Medicaid program. The MMA supports an expansion.

AUGUSTA — A band of health care providers speaking on behalf of the Maine Medical Association urged lawmakers Thursday to reach a bipartisan compromise to expand the state's Medicaid program to cover a larger group of low-income residents.

Scott Thistle/Sun Journal

Kenneth Christian, an emergency room doctor at Maine Coast Memorial Hospital in Ellsworth, speaks during a news conference at the State House in Augusta. Christian was among a group of health care providers and members of the Maine Medical Association who are urging the Legislature to expand Maine's Medicaid program, MaineCare.

Doctors and a nurse practitioner speaking during a news conference at the State House said they favor expanding access to health care because it would save lives and money.

Kenneth Christian, an emergency room physician at Maine Coast Memorial Hospital in Ellsworth, said too many Mainers depend on emergency rooms for their medical care.

"When the ill or injured show up at our doors, they get access to the attention and the care they deserve," Christian said. "But as good of a job as we do serving the public, I certainly wish that far fewer Mainers needed to rely on emergency rooms as their first, last and only access to health care services."

Expanding Medicaid would eventually see those individuals flowing into less costly and more efficient primary care practices, Christian said.

Others in the group, including Rhonda Selvin, a nurse practitioner and the associate medical director of Maine Quality Counts, said expanding access to health care could in the long run save money, but more important, it would save lives.

Selvin outlined a list of pilot programs designed to redirect low-income people to primary care practices. But many still seek medical care in emergency rooms, which often leads to duplication of effort or expensive diagnostic tests that may not be necessary.

"Having a CT scan one week and another CT scan the next week doesn't save costs," Selvin said. "And when we don't have providers that have access to this information, these types of patterns will continue. Primary care is the essential place where we need to develop both the communication and the service and the care for our patients, and without access none of these programs will follow through because they hinge on the fact that all of our patients have primary care."

Other speakers said they agreed with Maine lawmakers who support an expansion of MaineCare, but they wanted it to include reforms to help contain costs and create a culture of personal responsibility.

Phil Caper, a doctor with Maine Health Care, said he supported provisions in the bill before the Legislature's Health and Human Services Committee, including co-payments for those receiving Medicaid.

Caper and others in the group said emergency room visits likely would increase in the first few years of an expansion but would decline as people were filtered to primary care practices.

Asked what they would consider a deal-breaker on Medicaid expansion, Andrew MacLean, deputy executive vice president and general counsel for the MMA, said, "There is little we would categorically rule off the table. "

MacLean said the MMA was more skeptical about the concept of managed care. 

"In respect to managed care, we would say the devil is in the details," MacLean said. "We are waiting to see more specificity in what might be in a managed-care proposal."

The Health and Human Services Committee on Wednesday tabled LD 1578, the bill that expands Medicaid eligibility in Maine, while they negotiated on various amendments to the measure that might bring in enough conservative votes to pass it. 

Republican Gov. Paul LePage has remained firmly opposed to an expansion, saying it would cost Maine taxpayers too much with little improvement to health outcomes. LePage twice successfully vetoed bills in 2013 that would have expanded Medicaid.  

In his weekly radio address, LePage said hardworking Mainers would have to foot the bill for expanded Medicaid coverage.

"Welfare expansion will cost $800 million over the next decade, and Maine taxpayers would have to start paying millions immediately," he said.

According to the Affordable Care Act, the first three years of the expansion would be covered 100 percent by the federal government. After that, it would cover 90 percent of the cost.

Dr. Marguerite Pennoyer, an allergist and immunologist, said LePage's own rags-to-riches story may have turned out very different if he had been afflicted with a serious medical condition or illness as a young person.

"Health is fundamental, a prerequisite for anyone seeking to live a productive and independent life," Pennoyer said. "Expanding access to health care is the surest thing we can do to position people for advancement and to help end the cycle of dependency that grips so many."

She detailed LePage's life story of escaping poverty, seeking a higher education, becoming a successful businessman and eventually ascending to the highest office in state government.

"Now imagine a young man from Lewiston who is full of great potential but is afflicted with a chronic but treatable condition like asthma," Pennoyer said. "There are no rags-to-riches story for those who are debilitated by a curable disease. One cannot pick oneself up by the bootstraps when bedridden by a chronic but treatable illness."

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RONALD RIML's picture

So - he's an Affirmative Action Special Needs Governor

that the Republicans can work with.

You'da think we Lib'ruls would be jumpin' for joy....... Not!!!

JERRY ARIPEZ's picture

Expansion is the only right thing to do,some are getting it, not

Maine's idiot governor;

Utah To Expand Medicaid Under Obamacare, GOP Governor Announces

Herbert pointed to the 60,000 individuals in the state who will gain coverage under the state's expansion of the program, saying it's "not fair" to leave them without a solution.

In LePages's bizarro world he is just to plain stupid to get it....

He wants to see people suffer and leave them behind....

Vote the guy out of office and out of the state that HE as a teenager abused by utilizing the same services, he deny s others and more.


And I'm sure he's really

And I'm sure he's really looking forward to his upcoming trip to Brazil and Iceland. Funny, I don't see too many overseas businesses relocating here. But we incur the bills for his great adventures!

FRANK EARLEY's picture

Of all the places...............

Who does LePage have planning his trade missions. I'd be real curious to know how he came up with Iceland and Brazil. They just don't seem to be what I would consider prime trading partners. I remember reading about this trip, but I can't recall if he was heading there on his own, or does he plan to bring along some other Governors. I just can't remember anyone ever going to Iceland on a trade mission, especially in the middle of winter. On the other hand, I wonder if those beautiful beaches in Rio, are busy this time of year..............

AL PELLETIER's picture

Remember this one, Carolyn

Lobster feast baskets shipped out to 49 state governors. They got to eat, we got the bill and he got the thanks.

FRANK EARLEY's picture

How many more experts..............

How many more experts, medical professionals, and heath care advocates is it going to take to convince Paul LePage, that his reasoning is plain wrong. The frustrating part is that Lepage doesn't seem to realize the money saving benefits of having health insurance. Right off the bat, primary care physicians will promote a healthy lifestyle. They will perform routine scans which can pin point certain conditions at an early stage. Treating and controlling a medical condition is much less expensive in it's early stages. Routine physicals as well as access to things such as flu shots, and pneumonia vaccines will prevent a lot of emergency room visits with late stage development of these afflictions. More centralized medical records will also help reduce the redundancy in treating patients. No more having to under go that expensive test or procedure numerous times for the same illness.
The benefit of having many more people covered by insurance is that the number of unnecessary expensive unpaid emergency room visits will be reduced. The overall health of all those people as well as the hospitals being paid in a timely manner, will help reduce overhead and operating expenses. Thus making health care more affordable.
I think we've pretty much covered all the bases. Everyone seems to be on the same page. From the medical community, to the insurance industry to the general public. With the exception of Paul LePage and the Alexander Group, everyone seems to realize the benefits to expanding Medicaid, far out weigh using the out dated, broken and incredibly expensive system that we have been using for far to long. I feel that in the interest of the medical as well as financial well being of every single Maine resident, we need to insist that Paul LePage expand Medicaid, NOW..............

AL PELLETIER's picture

Who do you think Lepage believes?

Gary Alexander or the MMA?
By the way, Lepage is still stuck on that $800 million dollar figure that has already been debunked.


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