Medicaid expansion debate about health and money

Question 2: Medicaid expansion in Maine

AUGUSTA, Maine (NEWS CENTER) — The final few days of the campaign over Medicaid expansion are likely to see more TV ads, more messages and heated comments over a complex and controversial issue.

It's an issue the usual political process has been unable to resolve.

Democrats and some Republicans in the Maine Legislature passed Medicaid expansion five times since 2013, but each time it was vetoed by Gov. Paul LePage. Now, a citizen petition is forcing a referendum vote on the plan, but the arguments have remained essentially the same.

Supporters want to expand the Medicaid program to cover an estimated 70,000 to 80,000 adults, age 18-65, who are not currently eligible for Medicaid (also called MaineCare). Those people would need to have incomes below 138 percent of the federal poverty level, which is $16,643 for a single person and $33,948 for a family of four.

Supporters argue those people urgently need the coverage for a range of medical conditions. They also say an expansion would bring about $500 million in new federal money to Maine, which they say would help pay bills for Maine hospitals and other providers.

► Read more about the Yes side here: Mainers for Health Care, supporters of Medicaid Expansion

Opponents of expansion argue that Maine can’t afford it. They say the state would have to pay a portion of the cost for all those added Medicaid enrollees.

The Legislature’s Office of Fiscal and Program Review estimates the state general fund share of the cost would be more than $27 million the first year, and increase to more than $70 million in the third year. They argue that level of new spending would force cuts in other programs and possibly tax increases.

Opponents also claim the estimates by supporters have been "grossly underestimated," and that far more people would sign up for the program than the numbers being suggested, which would further increase costs.

► Read more about the No side here: Maine Votes No on 2...opposed to Medicaid expansion

There are many issues involved in the Medicaid expansion debate. The expansion is designed to get Medicaid medical coverage, which is essentially free to the individual for an estimated 70,000 to 80,000 Maine adults who can’t have it now.

There are arguments about the cost to Maine taxpayers, about whether many of those included under expansion actually have other affordable options now, and about other possible solutions to the problem.

There are also issues of financial help for health care providers who currently lose a lot of money providing free care to low-income people, and the current financial crises at many rural hospitals.

Here are additional thought on the issue from MaineHealth Senior Vice President Katie Fullam Harris and Community Pharmacies President/CEO and former legislator Joe Bruno:

WATCH: Katie Fullam Harris and Joe Bruno talk Question 2

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