Mayhew: Most vulnerable pay price of Medicaid expansion

AUGUSTA – Department of Health and Human Services Commissioner Mary Mayhew delivered the Paul LePage administration’s weekly address, focusing on Medicaid expansion, difficult decisions and priorities within DHHS’ target populations.

Here is her address:

Difficult decisions must be made in Augusta.  Tough choices are needed to ensure that state government can live within its means and that we can support and care for those who need us most.

Hello, this is Maine Department of Health and Human Services Commissioner Mary Mayhew.

Currently the Legislature is debating whether to add another 100,000 people to MaineCare, the state’s tax-payer funded healthcare program, at a cost of more than $800 million over the next ten years.

At the same time, there are thousands of elderly and disabled on waitlists for services to help support them in their homes and in their communities.

Most of us know someone in this situation.  It’s an 80 year old mother who is struggling to care for her 50 year old son with Down syndrome.    She needs help today and is worried who will care for her son when she is no longer around.

It’s the parents of an autistic child who should be celebrating the accomplishment of their child graduating high school. But instead, they are panicked because their child is being placed on an adult waitlist for critical support services.   Their child cannot be home alone.

Maine is one of the oldest states in the country and the demands for services will only be increasing in the years to come.   Everyone is worried about how best to care for an elderly parent, grandmother, aunt, or uncle.

These are real people – the elderly and developmentally disabled – and far too many of them are waiting for services.    The state needs more than $45 million to cover the services for these individuals.

There are tough decisions that must be made in Augusta.   We just finished paying off a $750 million debt owed to Maine hospitals because of the unbudgeted costs of the last expansion.   We cannot repeat history and expect a different outcome.

Democrats say that adding 100,000 people to Medicaid is somehow free, but we all know better.  Medicaid has grown by more than $1 billion over the last ten years because of previous expansions and the reality of healthcare cost increases.  It is nonsensical to believe that after years of financial crisis in Medicaid that the answer today is to add another 100,000 people to the program.    Don’t be fooled by efforts to combine expansion with a fancy legislative proposal to manage care in Medicaid.  The miraculous savings being advertised are not real and are only thinly veiled efforts to get support for a massive expansion of Medicaid.

We do not live in a world of unlimited resources.

If the state expands Medicaid our elderly and disabled will wait longer for services.  That is a price we cannot afford to pay.

Efforts to contain spending in the Medicaid program should be focused on meeting the needs of our most vulnerable and addressing other critical needs in state government like pay for state employees whose salaries have been frozen for years, investments in career centers to help people find jobs, or really funding education or helping to preserve important industries in Maine like lobstering, natural resources, and farming.

Government cannot be all things to all people and we must put our most vulnerable citizens’ needs first and ensure that state government is effectively prioritizing our limited resources in the best interests of the future of this state.