Mills’ Medicaid Raid Puts Vulnerable Mainers at Risk: Lockman

Will Republicans Join Democrats in Throwing Maine’s Elderly & Disabled Under the Bus?

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The clown show on the Kennebec returned to the State House for an encore appearance last week, and this time all the clowns were singing from the same page of the uni-party hymnal.

After five hours of public testimony before an ad hoc version of the Appropriations and Financial Affairs Committee on Dec. 21, all the Republican members of the committee joined with all the Democrats to give their unanimous blessing to Gov. Janet Mills’ request for nearly a half billion dollars worth of emergency spending for “winter energy relief payments” to 880,000 Mainers.

The full Legislature will vote on the bill when lawmakers return to Augusta on January 4th.

The spending spree is funded in part by a raid on federal dollars, including Medicaid matching funds. Medicaid is the joint state/federal program, known in Maine as MaineCare, that provides health coverage to low-income, disabled, and elderly Mainers, including nursing-home care and personal care services.

To fund her $450 checks to just about everyone in Maine with a heartbeat and a household income under $200,000, Mills proposes to spend $157 million in one-time federal Medicaid funding, most of it specifically earmarked for increased reimbursements to Maine’s chronically under-funded nursing homes.

More than a dozen Maine nursing homes have been shuttered in the past six years, imposing enormous financial and emotional burdens on residents and their families.

Also on the Governor’s shift-and-shaft hit list: Mainers on waitlists with intellectual disabilities, autism, brain injuries, and other related conditions. Mills wants to re-allocate $35.2 million in federal Medicaid funds earmarked for those individuals to pay for the one-time $450 checks.

Currently, there are just shy of 4,000 Mainers on the notorious Medicaid waitlists that date back to the Baldacci administration. Those numbers have increased every year Mills has been in office.

The message from Gov. Mills to Maine’s most vulnerable elderly and disabled residents is clear: Your lives don’t matter. If you’re on a waitlist for medical care, you better get used to it, because we have other priorities. Just in case you haven’t figured it out yet, the quickest way to get off a waitlist is to either die or move out of state.

Mills’ finance commissioner Kirsten Figueroa defended the re-allocation in her testimony, but not very convincingly. She claimed that spending the federal Medicaid funds on the waitlists and the nursing homes “would put the state at financial risk.”

Say what?

Here’s Figueroa’s argument in a nutshell: If the Legislature spent the one-time “windfall” on its intended purpose, that spending would be unsustainable in future years. 

In other words, if we use the Medicaid dollars to fund the waitlists, increase pay for healthcare workers, and boost reimbursements to nursing homes, we would have to commit to increased levels of funding in future state budgets to sustain that higher level of spending.

You can’t increase nursing-home pay and reimbursement rates temporarily, and then allow those rates to drop when your one-time federal funds run out. Why would anyone apply for those jobs under those conditions?

That would be unsustainable, as Figueroa correctly observed.

To sustain that level of spending in the future would require that legislators commit state funds to the waitlists and the nursing homes in every biennial budget going forward.

So it’s a matter of priorities.

Frankly, Maine Democrats have never prioritized Maine’s most vulnerable citizens. And now, it looks as if Republicans are poised to join the Democrats in kicking granny and her developmentally disabled son to the curb.

Alan Cobo-Lewis of Orono testified via Zoom during the public hearing. He has a 22-year-old son with a significant intellectual disability. Cobo-Lewis told committee members that his son went seven months without a single hour of direct support from Home and Community Based Services (HCBS) due to the Legislature’s refusal to fund the program during the last legislative session.

Cobo-Lewis pleaded with the committee to keep its hands off the $35.2 million of federal Medicaid funding earmarked for the waitlists. He even offered a solution that would have reduced the one-time “energy relief” checks from $450 to $410, while keeping the Medicaid waitlist funding for its intended purpose.

But his plea fell on deaf ears. Without any questioning by committee members, the committee chairs thanked him for his testimony and moved on to the next witness.

So here’s the question for legislators: without raising taxes, where will you find several hundred million dollars per biennium to fully fund the waitlists, the nursing homes, and the direct-care professionals?

Perhaps lawmakers could start by drilling down through Maine’s dysfunctional welfare system that offers annual benefits worth $71,757 – more than the median income for a Maine household.

Politicians in Augusta have transformed Maine’s social safety net into a hammock, as the workforce participation rate has dropped from 66.1% in January 2008 to 58% in November of this year – the lowest rate since 1976.

That’s a whole lotta able-bodied Mainers on the couch smoking dope and watching Netflix.

But there’s an even bigger gold mine of potential budget savings that would, if tapped, fully fund our obligations to low-income elderly and disabled Mainers.

That would be state funding of K-12 public schools, currently at a staggering $1.6 billion annually, without any accountability whatsoever for measurable results.  Enrollment has been in steady decline for decades, but spending goes up every year without fail.

As far back as 2007, only 36% of Maine 4th graders in public schools were proficient at grade level in reading. The same year, only 38% of 8th graders were proficient at grade level in reading.

Ten years later, in 2017, 4th graders were still stuck at 36% reading proficiency, while 8th graders advanced to a dismal 43%.

We’re churning out graduates who are unprepared either for the workplace or for further education. The dumbing down has been so systemic that most Maine high-school graduates who apply for admission to local community colleges need to take remedial courses before they’re ready for entry-level college work.

Will Republican legislators dare to propose flat-funding the K-12 sacred cow? That would free up hundreds of millions of dollars to eliminate the waitlists and begin reopening rural nursing homes.

Bear in mind that the GOP still has some leverage. Mills needs two-thirds supermajority votes in the House and Senate to pillage the Medicaid funds for her spending spree. She can’t do it with Democrats alone.

Perhaps the Republicans could offer to support spending $50 million from the budget surplus for low-income energy assistance – as proposed by the Governor’s bill – but not a dime from the federal Medicaid funds.

Making that offer will require political courage, and a willingness to fight fire with fire when the Fake News media circle the wagons around the swamp’s uni-party leadership.

How rank-and-file GOP legislators handle this will tell us a lot about their priorities going forward.

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