New study disputes LePage administration on MaineCare’s childless adults

AUGUSTA, Maine — The childless adults Gov. Paul LePage has proposed dropping from MaineCare are far from young and healthy, despite rhetoric to the contrary, according to a report released Monday by an advocacy group for the poor.

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Gov. Paul LePage

More than 40 percent of childless adults covered through MaineCare are older than 45 and many have serious medical conditions, states the report prepared by Maine Equal Justice Partners. Known as “noncategoricals” because they don’t fall under categories of mandatory coverage, the childless adult group consists of beneficiaries ages 21 to 64 who don’t qualify as disabled under federal guidelines and who have no dependents in the home.

“We think it’s critical that [lawmakers] have an accurate picture of who’s being served,” Sarah Gagne-Holmes, executive director of the left-leaning organization, said at a State House press conference Monday. “Despite the rhetoric that noncategoricals are young and able-bodied, the evidence is very different.”

Of members receiving services, 47 percent have a diagnosis of disease or cancer, 24 percent have a mental disorder and 11 percent were treated for injury or poisoning, according to April 2010 data cited in the report.

The report includes the personal stories of seven noncategorical adults who were identified through a network of organizations allied with Maine Equal Justice Partners, Gagne-Holmes said in an interview. Sandra Butler, a professor at the University of Maine School of Social Work, interviewed the seven participants, and Dr. Laurel Coleman, an attending physician at the Geriatric Assessment Clinic at Maine Medical Center who specializes in Alzheimer’s disease and palliative care, reviewed their medical conditions.

Adrienne Bennett, press secretary to Gov. Paul LePage, disputed the report, saying the average age of a noncategorical recipient is 40 years old.

“We’re not talking about the elderly and we’re not talking about the disabled,” Bennett said.

May statistics provided by the Department of Health and Human Services to the Bangor Daily News on the demographics of the noncategorical group list an average age of 40. Those ages 45 to 54 make up the single largest age group in the childless adult program, but 60 percent of beneficiaries are between 21 and 44, according to the data.

Bennett also said several MaineCare recipients who spoke at Monday’s press conference represent the exceptions rather than the norm. They were not among those interviewed for the report, who were promised confidentiality.

“The individuals we represented are illustrative of the conditions that many people on the noncategorical program have,” Gagne-Holmes said.

MaineCare never was intended to serve as universal health care, Bennett said. “It’s been branded as a way to provide affordable insurance to everyone, but we don’t have the money,” she said.

Calls and emails to Joel Allumbaugh, director of the Center for Health Reform Initiatives at the Maine Heritage Policy Center, were not returned by Monday evening. MHPC has been supportive of the governor’s proposed cuts.

The state expects to save about $22 million in fiscal year 2013 by eliminating noncategoricals from the rolls. The cuts would take effect on July 1, 2012.

The state also will forgo $37 million in federal funding while shifting that cost to the private sector, the report notes.

Noncategoricals represent about a third of the 65,000 Mainers facing a full loss of coverage under LePage’s plan, designed to close an estimated $220 million shortfall in the Department of Health and Human Services budget over the next year and a half.

Michael Powers, 42, of Portland said at the press conference that he has gone from being a “hopeless statistic” to a “worthy competitor” in large part because of MaineCare. Less than three years ago, he was homeless. Now he’s in stable housing and taking classes at Southern Maine Community College. Powers said he wants a productive life where he has no need for MaineCare, but building one will be far more difficult if he loses health care coverage.

The number of childless adults on MaineCare has nearly doubled to 19,000 from about 10,000 at the beginning of 2010, though it remains lower than a peak of 24,000 in 2005. Another 14,000 to 16,000 childless adults remain on a waiting list for MaineCare, Stefanie Nadeau, director of MaineCare services, said in mid-December.

The report also points out that Maine is one of 20 states offering some form of coverage to low-income adults. Most of those states, like Maine, offer a package of limited Medicaid benefits, while others offer a full Medicaid package or similar set of benefits.

To be eligible in Maine, recipients must earn no more than the federal poverty level, or $10,890 annually for an individual. Those earning up to $32,670 qualify for more limited coverage under the state’s Dirigo Health program.

Dirigo doesn’t have the funding to cover the childless adults now receiving coverage through MaineCare, said Joe Bruno, chairman of the Dirigo Health Agency board.

“If all those people all of a sudden shift to Dirigo, we don’t have enough money to give out that subsidy,” he said.

Dirigo is funded through state dollars, while MaineCare, the state’s version of Medicaid, is a joint state-federal program.

Beginning in 2014, all states will be required to provide Medicaid coverage to eligible childless adults under the Affordable Care Act.

The Legislature’s Appropriations Committee is scheduled to meet tomorrow afternoon to continue deliberations on the DHHS budget.

Bangor Daily News writer Eric Russell contributed to this report.

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Comments

FRANK EARLEY's picture

I was a noncatagorial

When I was 42 or 43 I got sick. I was working for a very good company. I tried for six months to work but was sent home time and again by my supervisors, I can't blame them.
I was lucky I had full health insurance, so being a noncatagorial didn't mean anything to me. If I was I would have been screwed. If I had no insurance one of two things would have happened. I would have died, or I would have accumulated more medical bills than I could have ever paid back. You see, in the beginning you have to see many doctors each of them require a slew if tests. I'm not talking about that guy who has a back ache that won;t go away. If they do have the ache, a cause can usually be found, or pain relief can be accomplished.
I had an unknown disease at least at that time but it took me five years of surgery and numerous specialists to finally diagnose my condition. Its degenerative incurable and there is no treatment for it.
I know I'm babbaling on here but remember one thing, I was only 42. If I had no insurance I would be in a nursing home now, only because my enormouse debt that I owe the medical industry. Nursing homes don't give thier servises away. Just think of how many people the state would be covering without some sort of help. I've paid taxes all my life I don't mind it going to help people.
I'm living comfortly now, I'll never be able to work again. I get Social securaty disability, I pay my own medical insurance and presciptions, as well as all my bills.
I guess what I'm trying to say is I'm not a drain on the state, I very easily could have been. Health insurance made the differance.

DONALD FERLAND's picture

I would like to see the

I would like to see the numbers on how many of these "noncategoricals" are actually college students who were on Mainecare because they come from a low-income household and have aged out of the program due to turning 21. Whatever that number is, should we cut these childless adults at this time and punish them for improving their lives and leave them with no coverage?

 's picture

"Known as “noncategoricals”

"Known as “noncategoricals” because they don’t fall under categories of mandatory coverage, the childless adult group consists of beneficiaries ages 21 to 64 who don’t qualify as disabled under federal guidelines and who have no dependents in the home."
Also known as "not my damn problem". You're an adult. Get a damn job. Can't afford insurance... I can't afford to hear you whine about it.

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