Voting no on Medicaid expansion

By Paula Sutton | Oct 10, 2017
Source: File photo

This November Maine voters will decide if state taxpayers should expand Medicaid to non-disabled, working-age adults. Deciding on issues as complex and emotional as this at the ballot box concerns me, and I would like to share some facts.

Medicaid is not the same as Medicare. Medicare is a 100 percent federally funded program and is for retirees, who generally have paid into the program for many years. Medicaid is a jointly funded program between the federal government and individual states and already covers very poor seniors, pregnant women, poor parents, children and the disabled. States have different names for Medicaid; in Maine it is called MaineCare, which is not to be confused with Medicare.

Since Maine already tried this experiment in 2002, researching this proposal was simple. It was not a success. At the time, advocates said that it would reduce uninsured rates and charity care at hospitals. It did not. Advocates said it would grow the economy, but in fact gross domestic product growth after expansion was substantially slower than during previous years.

So what did happen? Many people who were paying for their own health insurance simply dropped their plans in favor of a free government program, and the population of Mainers who were on Medicaid grew from 14 percent to 25 percent. The cost of this expansion caused the state budget to explode, with red ink taking money away from education, infrastructure and other key programs. Maine hospitals were forced into layoffs and medical cuts because the state was unable to pay its bills, and hospitals were owed $750 million.

There are similar trends in other states that expanded coverage. Significant cost overruns are being experienced in California, Kentucky, North Dakota, Oregon and many other states.

While the federal government is promising to pay for 90 percent of the cost of expansion, we need to ask ourselves “Where does the federal government get their money?” The obvious, but often overlooked, answer to this question is they get their money from us. Considering the chronic chaos and confusion in Washington, I’m uncomfortable believing they will uphold this promise.

Other key aspects to note:

The potentially damaging aspects of estate recovery should be made fully known to recipients. Estate recovery can occur when the state puts a lien on your property to pay for services rendered, sort of like a reverse mortgage. I know a man who took care of his elderly parents, and in return they promised to leave him their house. In the end, the state claimed the property because the estate was needed to pay back the money that had been spent on their care. As the working poor try to establish equity for their families, they may invest in a home or property, but can lose it all after they die. With real insurance, there is no estate recovery. As states' budgets continue to tighten, it only seems likely that this sort of occurrence will increase.

Currently, individuals earning 100 percent to 138 percent of federal poverty level may purchase subsidized insurance on the exchange. But, if the ballot question passes, this option will no longer be available, and they will be forced into the Medicaid program. Medicaid’s low reimbursement rates make it inferior, and many doctors resist accepting it. This may result in the inability of patients to keep their doctor once on Medicaid.

Under current law, a person earning minimum wage and working just 26 hours a week qualifies for heavily subsidized private health insurance on the exchange. Private health insurance is always preferable, because the reimbursement rates are always higher. Doctors and hospitals always prefer it over Medicaid, which is considered the payer of last resort.

Without expanding Medicaid, a single male at 100 percent of federal poverty level, aged 30, can buy a “silver” insurance plan for less than $15 per month. Having some skin in the game makes all the difference and will incentivize recipients to use benefits wisely, which in the end saves all taxpayers money.

Medicaid is generally only available for services in state. With our shortage of doctors if a Medicaid/MaineCare patient needs cancer treatment or if they develop a rare disease, they may not be able to seek treatment in another state. Real insurance is portable, Medicaid is not.

With an estimated cost to the state of Maine of at least $400 million over the next five years, combined with the above information, I will be voting no on Question 2 and ask that you join me.

Paula Sutton, R-Warren, is the state representative for House District 95.

Comments (12)
Posted by: Richard McKusic, Sr. | Oct 18, 2017 16:08

VOTE, please, VOTE! I voted absentee ballot at Rockland City Hall 8:30 Monday morning. This is too serious to let slip by without being heard. This is life or death for some of our citizens.  Pro Life means from conception to death or it is meaningless. Get an absentee ballot, get it done and feel good that you have done your part.

Image result for pro life from conception to death\

Posted by: Ronald Horvath | Oct 18, 2017 11:54

Oh, Martha, haven't we heard that old right wing white noise about "coddling the poor" for long enough?  Will you people ever change your tune?  It's almost as tiresome as the complaint that the media is "liberal."  You really mean factual, don't you?  Isn't that what bothers you, that they report what's actually there instead of what you want to see and hear?  (Yes, I know, the left is just as bad.)

Well, in any case, even though I find your concern for the "truly needy" touching I still find it difficult to understand how conservatives can be so obsessed about people with next to nothing getting anything for free, anything that -in your opinion- they don't deserve, anything that they didn't work for -though in truth the working poor work harder than anyone.  Even then they need help since companies like Wal-Mart have learned how to milk the system for the necessities of life that their slave wages won't provide -6.4 billion from the public larder at last count.  This is becoming common practice hence the efforts for a "living wage" from corporations that can well afford it but prefer higher profits to "humanity."     

"When plunder becomes a way of life for a group of men in a society, over the course of time they create for themselves a legal system that authorizes it and a moral code that glorifies it."  -Frederic Bastiat

Ad yet I Republicans pour vitriol on the working poor as though they were an enemy.  I admit that for years I've wondered what is wrong with anyone so narrow of spirit and closed of mind that they see anyone in need as suspect.  Nowadays the right has become almost pathological in their denunciation of anyone without the means to contribute to their campaign funds.   

And yet the other side of this political question doesn't seem to bother you at all.  The fact that Trump and the Republicans are determined to strengthen the established economic elite by bankrupting the government just to give them a 2.4 Trillion dollar tax break -which is suspiciously almost the same amount that they have stashed in overseas tax havens- doesn't bother you at all.  The fact that this country was founded by revolution against that very system of inherited wealth and attending political power makes me consider that the right has probably been running an underground movement against democracy since 1776 and now sees Trump -foul as he is- as their best, last hope to finish off this great social experiment at last.  Well, I've always said that if democracy is rule of the people than Republicanism is rule only of the "right" people. If you're so concerned with " lazy parenthood and a generation that only wants to play with their cellphones and have everything paid for them" then why create an elite class than does even less?  Why make things harder for the majority just to make it easier for a minority? Why create a entire overclass of Trumps who consider loyalty to their wealth more important than loyalty to their own land and people (and are willing to collude with an enemy to preserve it)?  So it is that aristocracies are born.

“… an entrenched aristocracy such as those that ruled and oppressed most Latin American countries for most of the last two hundred years, can also crush any innovations in political or economic thought as being a threat to their own social and political hegemony.”  -NIALL FERGUSON, from his review in the NYTs entitled "Overdoing Democracy."

And aren't those trillions in giveaways to the rich going to add to "higher debt to our grandchildren" while adding nothing "to our humanity?"  Or is it the plan to drastically underfund every aspect of government to save cash?  I suspect it is.  Trump is already hobbling the veterans hospitals by refusing to hire staff.  Republicans love this method.  Once it's done they can point and say, "See, we told you government doesn't work."  Attempts at privatization soon follow.  Handing over public services to capitalist overlords is the quickest way to establish corporate control over society as a whole.  After all, no one "elects" CEOs.  

"Giovanni Gentile, the “philosopher of fascism” and ghostwriter for Mussolini, said of the definition of fascism in the Encyclopedia of Italiana: “Fascism should more appropriately be called corporatism because it is a merger of state and corporate power.”   (Sounds like Republicanism to me.)

Your "personal responsibility" argument would hold more water if conservatives took any responsibility for anything.  Certainly Trump takes none for his multiple sins.  Of course every time a conservative gets caught with his hand in the til -or his pants down- he cries that God will forgive him and that's good enough for the faithful.  He's back to square one.  That's a religion of convenience if ever there was.

In case you doubt it:  "In the 28 yrs that Republicans have held office over the last 53 yrs they have had a total of (a drum roll would be more than appropriate), 120 criminal indictments of executive branch officials. 89 criminal convictions and 34 prison sentences handed down. That's more prison sentences than years in office since 1968 for Republicans."

As for " leaving hospitals and doctors holding debt that it has to pass on to others," it's not a new concept.  Republicans were good with it for years before health care become a political liability they could no longer ignore.  As always debt, for the right, is only an issue when they think they can pin it on someone else.  As Cheney once blurted out "Deficits don't matter.  Reagan proved that."  Indeed he did, tripling it during his administration.  Again, conservatives can commit any sin of which they accuse others because their base ignores what it doesn't want to see.  Trump proves that every day.

Well, sorry for the "heat" but that's the way of things in this information age.  I'll just leave you with what I think is the best definition of "humanity."

“This is the duty of our generation as we enter the twenty-first century -- solidarity with the weak, the persecuted, the lonely, the sick, and those in despair. It is expressed by the desire to give a noble and humanizing meaning to a community in which all members will define themselves not by their own identity but by that of others”.- Elie Wiesel

Posted by: Martha Johnston-Nash | Oct 18, 2017 07:08

If you really want to know why supporters are not remarking, perhaps you need to understand that 1) the media is directed mostly to liberals, with their liberal slant and therefore more and more conservatives are finding the real news elsewhere. And when they do post or try to bring reason to an article, 2) they are immediately slammed by those who think the mainstream media is bringing them the whole truth.

Having made that point, let me address a couple of things from the comments. 1. When you say you'll choose humanity over budget, you do realize it's that attitude that has produced lazy parenthood and a generation that only wants to play with their cellphones and have everything paid for them? Yes, we need to take care of those who cannot do for themselves; but when we give and give and give to those who simply need to take responsibility for themselves, we do them no service and we take away from those who are truly needy. Rep. Sutton knows her facts, and she is right that many will (again) drop their coverage to get "free" benefits.

2. Rep. Sutton is in the State Legislature, not the U.S. Congress. She has no control over what Medicare does.

3. Having studied economics and macroeconomics, I can't help but wonder at the comment over guns vs butter. When people take responsibility for themselves and work for what they need and want, we are all better off. Again, those who cannot do for themselves deserve our help; and those who can, who take for free, take away funds we could use to benefit the needy.

4. To Ms Reider, perhaps you need to live here a bit longer to understand that the Governor is right. He lived through it, he took care of what the Democrats wouldn't. And because Maine receives more than it gives makes what sense in taking more? The money comes from somewhere, it's not magically found growing on Federal trees. Does leaving higher debt to our grandchildren add to our humanity?

5. The government takes very little to administer? The only thing government has done, is say it will only pay cents on the dollar for all the medical bills. That leaves hospitals and doctors holding debt that it has to pass on to others. Mr. Macroeconomics should understand that concept.

6. I know I'll take heat for remarking, but you need to take off your liberal blinders and use your noggin to figure this out. And yes, I will be voting NO and hope others will join me and Rep Sutton.

Posted by: Harold Bryson Mosher | Oct 12, 2017 09:08

There doesn't seem to be much agreement with Paula Sutton in the comments so far.  Does that tell you anything, Paula?  I'll be voting yes on question 2.

Posted by: Robert M Rosenberg | Oct 12, 2017 07:12

Maine Medical Assoc. came out in favor- as did Nurses Association. Vote yes!

Posted by: Richard McKusic, Sr. | Oct 11, 2017 13:33

Thank you, Mr. Hall. "Unlike insurance companies, which take $0.25-$0.30 of every dollar right off the top of any medical bill they choose to pay, Federal health programs, like Medicaid, Medicare, and yes the Veterans Administration, take only a two or three cents of each dollar to administer their programs." Enough reason right there to VOTE "yes".

Image result for vote thePower in Your Hands

Posted by: Seth Hall | Oct 11, 2017 09:27

Ms. Sutton is part of the same lame, fact-free, ideologically driven group of know-nothings (some people call them Republicans), that do the bidding of the wealthy 1%, and care little or nothing for their neighbors in need.

Unlike insurance companies, which take $0.25-$0.30 of every dollar right off the top of any medical bill they choose to pay, Federal health programs, like Medicaid, Medicare, and yes the Veterans Administration, take only a two or three cents of each dollar to administer their programs.

And as another commenter remarks, Ms. Sutton and her Congressional colleagues can craft more  or less any bill they prefer, including one that avoids onerous things like estate recovery.

The reason we have been having so many referenda in Maine in recent years is that the Legislature, and especially the Administration, are simply not doing their jobs; they ignore the people's needs and interests in the face of the corporate master's demands.

As they say: the truth will set you free...    alternate facts never will!

Posted by: Susan Reider | Oct 11, 2017 08:12

Ms. Sutton presents several disingenuous points in opposition to expanding Medicaid in Maine. First, it will cause the state budget to explode, which allegedly has happened before. I have lived in Maine only for a few years but I have been hearing the same thing from the LePage administration every time voters want to directly address the issues of poverty, education and workforce development through state programs, particularly those that could attract more federal funding. A quick fact: Maine receives $1.45 back for every tax dollar sent to Washington. Maine Republicans seem to be content with riding the national economic recovery without doing a single thing to address the unique challenges of our state. Perhaps if they feel inadequate to lead, they should step out of the way. Second, Ms.Sutton threatens estate recovery. That can easily be fixed by state law, Ms. lawmaker. You can do your job. Third, she remarkably says insurance on the exchange is better than Medicaid! What have you done to bolster Republican support for Obamacare, Ms. Sutton? I would like to hear from health care providers on this issue. Republicans like Ms. Sutton have totally lost their credibility.

Posted by: Patrick Michael Florance | Oct 11, 2017 08:00

Vote YES in November!


Posted by: Robert M Rosenberg | Oct 11, 2017 06:59

Typical BS with a lot of smoke and mirrors. The federal government would have paid for Medicaid expansion in Maine but our "esteemed governor chose not to accept it. Now premiums for insurance through the ACA are going up due to uncertainty caused by our current prez. Some people need this safety net- the working poor, for example; single, working parents also. Medicaid expansion would have helped a lot of families over the last 6 years. It is important to vote YES in November

Posted by: Richard McKusic, Sr. | Oct 10, 2017 16:23

I choose to vote on the side of humanity.

Guns versus butter model

In macroeconomics, the guns versus butter model is an example of a simple production–possibility frontier. It demonstrates the relationship between a nation's investment in defense and civilian goods. In this example, a nation has to choose between two options when spending its finite resources.

Image result for guns or butter

Posted by: Mary A McKeever | Oct 10, 2017 14:10

A very clear and comprehensive article and it  perplexes the mind. I see both sides of this issue and it all comes down to money and not humanity. As a retiree I am fortunate to have private insurance. But as the bible says, "the poor will always be with you", not a true quote but close enough. I pray for a swift resolution of this dilemma.

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