Lawmakers on Maine’s Health and Human Services Committee will hold a public hearing Monday on LD 1984, “An Act To Eliminate Waiting Lists for Home and Community-based Services for Adults with Intellectual Disabilities, Autism, Brain Injury and Other Related Conditions,” a bill that would make it the official position of the state to end waitlists for disabled Mainers in need of health care services.
One would think taking care of Maine’s most vulnerable citizens is already a priority of our leaders in Augusta, but Governor Mills on her first day in office declared expanding Medicaid to able-bodied adults without dependents was more important. The biennial budget approved by lawmakers in 2019 dedicated $125 million to expanding Medicaid while keeping waitlists intact for individuals with disabilities seeking services under the MaineCare program.
Despite the large cost that would come with eliminating the waitlists, LD 1984 is worth pursuing because one of the primary roles of government is to help those who are truly needy, including individuals with brain injuries and intellectual and developmental disabilities. These individuals count on the safety net and our public dollars should be reserved to help them. Put simply, this is the population Mainers expect to help with their hard-earned tax dollars.
According to 2019 data from the Department of Health and Human Services, the cost to fund waitlists under MaineCare sections 18, 19, 20 and 21 would be more than $210 million annually, or $420 million over a biennium. This would no doubt be an expensive endeavor, but it is the right thing to do. However, in ending the waitlists, lawmakers should exercise caution – the current budget surplus of $120 million is not large enough to cover the entire cost of eliminating the waitlist.
This means funding that is already allocated to specific services might need to be reduced or eliminated to fund the priorities laid out in LD 1984. A large chunk of the existing waitlists could be eliminated with the funding that was used for Medicaid expansion, and it would be wise to use this money to help the truly needy instead of able-bodied adults. While Mainers enrolled in Medicaid expansion may need help financially, they have the ability to help themselves in some capacity whereas most on the waitlists cannot.
Without using the surplus and reallocating appropriated funds, the only other avenue to fund LD 1984 would be to raise taxes which is not recommended. Unfortunately, lawmakers and the governor increased total state spending by more than 10 percent during the First Session without addressing this urgent need. Eliminating the waitlists should have been a priority when the funding was available.