Message to governor: A budget cut is not a cut if taxpayers end up paying the bill, anyway.

And that, we fear, would be the result of Gov. Paul LePage’s plan to remove as many as 30,000 adults from the state’s Medicaid program.

This is a new budget cut the governor is proposing to deal with a recently announced $164 million shortfall in state revenue.

“The generosity of the state of Maine has been so great over the last decade that we’ve dug ourselves a big, big hole,” LePage told the Capitol News Service.

Yes, we have been generous. But we have also been smart in providing care to people early and in the least costly way.

The governor’s cut would remove about 12,000 parents who earn between 133 percent and 150 percent of the federal poverty level from the MaineCare rolls, saving the state about $6 million.

Their children would continue to receive coverage, but the parents would not.

His plan also would eliminate coverage for 16,000 childless adults, saving about $11 million in 2012.

Here’s the rub: These people are poor, and comprehensive medical coverage is truly out of their reach.

Yet, denying them coverage won’t keep them from getting sick, and it won’t keep them from seeking medical help.

In fact, hospitals are required to treat people who show up at their doors, whether or not they have health insurance coverage.

Eliminating their coverage simply means they will not receive the lowest-cost form of medical care, from a family doctor, or preventive care.

So, when they have a really nasty sore throat, they will go to an emergency room rather than a doctor’s office.

When they have a severe mental health issue, they will end up in a police cruiser or a jail cell rather than a counselor’s office.

When they can’t afford a prescription, they will show up at some city’s General Assistance office.

The state will indeed save $17 million. Hospitals, meanwhile, will end up with $20 or $30 million in write-offs for uncollectible bills and charity care.

The hospitals then will cover that expense by increasing rates for their insured customers.

It’s a financial shell game, all right, and it means individuals and employers who pay for their health care coverage end up paying directly for people who cannot.

The other result could be tragic, as several people who testified at a hearing Thursday pointed out.

Adult women will skip mammograms and Pap smears, and men will go for years without prostate and colorectal cancer screenings. Others will struggle with undiagnosed high blood pressure or diabetes.

Some of those people will show up at a hospital with a tragic and costly terminal illness that could have been prevented by routine care.

Cutting MaineCare coverage for these folks could help solve the governor’s immediate problem, a budget shortfall.

But it would only do so by shifting that expense to other levels of government, to hospitals and eventually to taxpayers and the state’s employers.

And that’s no “cut” at all.

rrhoades@sunjournal.com

The opinions expressed in this column reflect the views of the ownership and editorial board.

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