Gov. Paul LePage and many of the Republicans in the Legislature like to talk about making tough choices.
But when it comes to their efforts around health care, the choices they are making aren’t tough. Instead, they are cruel, ideologically driven and unnecessary. But worse, they will likely cost lives.
This year, LePage forced through cuts in Maine’s Medicaid program, which is called MaineCare, that would take health care coverage away from thousands of low-income people in the state. While many of his cuts are likely illegal – against both Maine law and federal law – the intent is clear.
The governor and his supporters want to destroy public health programs that have over time expanded accesses to quality health care for Maine families, many of them working and still unable to afford insurance.
To pass their extreme health care agenda, they like to focus on numbers. First, they manufacture a financial crisis with ill-advised tax cuts for the rich and then, crying poverty, say they have to make “tough” choices to reduce health insurance access.
For working families who are really forced to make tough choices – to decide between medicine and food, rent and heat, and paying the mortgage and sending the kids to college – the rhetoric makes sense.
Especially if they don’t follow the details too closely. But the details matter.
Right now, the governor is using a Harvard study to defend his all-out assault on public education. The governor would like to privatize more schools, drive out teachers and especially the teachers’ union and turn the system over to for-profit corporations.
To make his point, he touts a Harvard study that says Maine’s educational attainment hasn’t improved as fast as other places. What he fails to mention is that Maine hasn’t improved as much as other places because our state was starting in good position to begin with.
According to the BDN, the governor actually said: “I don’t care where you go in this country. If you come from Maine, you’re looked down upon.” Such self-hatred permeates his public policy.
The governor likes Harvard studies, I suspect, when they can be twisted to fit the tall tale he is pushing. But I’m betting he’s less interested in a different Harvard study that suggests his attack on Medicaid will cost people their lives.
The New England Journal of Medicine last week published a Harvard study comparing death rates in states that had increased access to health care through expanded Medicaid programs to states that had not.
Maine was one of the states with an expanded program, along with New York and Arizona. They were compared to other states that had not worked as hard to make sure as many people as possible had access to health care, including New Hampshire, Pennsylvania and Nevada.
The results shouldn’t be shocking. But they should keep us all up at night as we think about the policy decisions we have allowed LePage and his supporters to make.
From the report: “State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care and self-reported health.”
In other words, fewer people died in Maine than would have were it not for expanded Medicaid.
According to the study, mortality reductions were greatest among older adults, nonwhites and residents of poorer counties.
The expansions reduced deaths by 6.1 percent or almost 20 people per 100,000 adults.
We don’t know their names, but hundreds of people are alive in Maine who might otherwise have died because of public policy that put a premium on making sure as many people as possible had access to health care.
Janet M. Currie, director of the Center for Health and Well-Being at Princeton put it this way to the New York Times: “This says, well there is a benefit to giving people insurance. Maybe you don’t want to pay the cost, but you can’t say there’s no benefit.”
It seems like common sense. People who have insurance can go to the doctor when they are sick, can catch problems earlier and can get more consistent care. Of course their health will be better, and they will live longer.
But in our current political debate – dominated too much by people who cater to corporations over the middle class and working families – ideological opposition to government programs, like Medicaid, means that more people must confront poor health and early deaths.
For no good reason.