Back in November, the people of Maine voted in favor of expanding Medicaid access to more Mainers. As a doctor practicing in Rumford, I was excited, thinking of how much this would benefit many of my patients. Yet, despite the clearly stated will of the people of Maine, the Legislature and governor have not taken the necessary steps to implement Medicaid expansion.

The expansion, which would require the state of Maine to pay only 10 percent of the costs with the rest supplied by the federal government, makes perfect sense for Rumford and other similar communities. Many citizens would gain much-needed access to insurance; rural hospitals would have a decreased risk of closure; and the state’s economy would improve.

Despite such obvious benefits and the fact that the Medicaid expansion ballot measure passed with an 18-percent margin, the governor and Maine’s Legislature have taken no steps toward enacting this law.

For many in Rumford, health insurance and health care is an expensive luxury. Because people in the area were hit disproportionately hard in the economic downturn, Rumford’s median income is low compared to that of the rest of the nation. That makes it difficult for most people to afford private insurance. Additionally, many of the jobs available in Rumford do not offer company-sponsored insurance as a benefit, making private insurance even more expensive.

With Medicaid expansion, an increased number of Rumford’s citizens would qualify, granting access to preventive health care and medication coverage that would have been previously too expensive without insurance.

Having a larger population of insured people leads to greater financial security for rural hospitals. With more patients insured, hospital systems no longer need to spend as much of their budget on “charity care” — taking care of patients who can’t afford to pay their medical bills. It would also lead to decreased private insurance premiums, as hospitals will not have to offset their costs by charging more to private insurers, not to mention the decreased costs from improved access to preventive health care and treatment of chronic conditions. Patients could afford to be seen at their doctor’s office, instead of having to wait until a problem becomes an emergency.

Though many worry about the cost of Medicaid expansion, increasing access to Medicaid will actually improve the economy of Maine. As hospitals gain financially, they will look to expand their work force, opening up more skilled jobs with good pay. Additionally, under the current system, many Mainers have to resort to living on disability in order to get Medicare so they can afford their medical treatment. Under expansion, many of those people would qualify for Medicaid and can re-enter the work force.

Most importantly, the money is available. The most recent report from the Revenue Forecasting Committee predicts a surplus that would cover the cost of Maine’s Medicaid expansion with plenty to spare.

There is no excuse to deny Mainers access to affordable health care. Medicaid expansion makes sense for Mainers, which is why a majority voted for it in the first place. However, the Legislature has done nothing with the issue since November and the deadline to act is swiftly approaching. Representatives must act on this before it is too late.

Kathryn McLellan, MD, is a family medicine specialist in Lewiston. She lives in Auburn.

Kathryn McLellan

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