Republicans at the State House are celebrating what they see as a great victory in blocking Maine from enrolling 70,000 people in the Medicaid program at federal expense.
The override attempt of Gov. Paul LePage’s veto fell two votes short in the House; by most accounts, the Senate would have overridden.
But the “victory” will almost certainly prove Pyrrhic, for, despite the strange and improbable tales Republicans kept telling themselves, a solid majority of Mainers does not agree with them.
For the moment though, the GOP seemed giddy. During the House debate, Rep. Heather Sirocki, R-Scarboroug, began quoting from Don McLean’s classic song, “American Pie.” What relevance this had to health care was unclear, but Sirocki went on and on until finally being gaveled down by Speaker Mark Eves on a point of order.
At week’s end, the outcome of the budget fight was still unclear – LePage kept announcing a veto but not delivering it – but the Medicaid expansion is dead for this year. And those likely differing results owe much to House Republican Leader Ken Fredette, who voted for the budget but made the cause of blocking Medicaid his own, at times sounding even more fanatical than LePage himself.
A low point in the session’s rhetoric – and there were many – came when Fredette issued a news release contesting the idea Senate assistant Republican leader Roger Katz came up with, authorizing Medicaid for only the three years of 100 percent federal funding.
Taking the money, Fredette opined, would be like “checking into the roach motel” – a reference to a long-ago ad for insect traps. What providing health care for thousands of poor, but employed Mainers has to do with exterminating bugs is also unclear, but someone should have called, “Rewrite!”
Seen logically, the LePage-Fredette position is pitifully inadequate. If the federal government had offered $750 million to Maine to do just about anything else – build bridges, invest in research, create a new military base – the Republicans would be falling all over themselves to grab it. But because the money is intended to provide health care for Mainers who have no hope of getting it otherwise, it just can’t be.
While they go on and on about the cost of “government” health care, they ignore that “private” health care costs far more. Medicaid is, person for person, the most efficient form of payment we have. Contrary to legend, it provides only the basics. And it’s among the more functional parts of a wildly dysfunctional system that costs twice the average of all other developed nations in the world, while leaving 50 million Americans uninsured.
LePage actually said this week that “Everybody should have health care,” but hasn’t offered even the slightest clue how that could happen. His assault on the Affordable Care Act has already made Maine a poorer place – our insurance exchange, which LePage insisted the state shouldn’t design, likely won’t be ready by the Oct. 1 deadline. He won’t “lift a finger” to help with ACA, but has no alternative.
But what about Fredette? Educated at the University of Maine Law School and Harvard’s Kennedy School, he certainly knows his way around public policy. He knows that the AFA isn’t going away, that President Obama’s re-election, the Supreme Court’s ruling upholding it and the lack of any plausible Republican plan, means it’s here to stay.
His decision to block action means only that the issue will be back next year, bigger than ever. The most likely vehicle would be a referendum campaign, which would come first to the Legislature and provide one more opportunity for Republicans to change their minds.
Talk around the State House is that the LePage administration may be beyond salvaging, but wouldn’t some GOP lawmakers like to be re-elected?
After the defection of (now former) tea party icon, Arizona Gov. Jan Brewer, from the “no Medicaid” cause, there really aren’t any clothes for Republicans to wear. And here, historical perspective may help.
When Medicaid was created at President Lyndon Johnson’s behest in 1965, states had the option of signing on, or not. Even though the terms were less generous – a 50-50 split for the wealthiest states, more for lower-income states like Maine – nearly half did in the first year. After three years, every state was on board, except one – Arizona. It held out 17 years, until 1982, when it began the nation’s 51st Medicaid program.
If Arizona can do it, so can Maine. And so for the rest of the 50 states. The longer Republicans try to block a rational, if imperfect, health care law, the greater the adverse consequences for everyone.
Douglas Rooks is a former daily and weekly newspaper editor who has covered the State House for 28 years. He can be reached at [email protected].
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