Mills right to reject failed GOP policy on health care

In a major victory for sound public policy over naked politics, Gov. Janet Mills continued her efforts to expand access to health care to Maine people.

This time, she bucked the Trump administration and former Gov. Paul LePage by rejecting a change to the state’s Medicaid program, which would have erected unnecessary barriers to health insurance for low-income families.

Gov. Janet Mills. Troy R. Bennett | BDN

The policy changes, which LePage sought and the Trump administration granted, are often referred to as “work requirements,” meaning that a person receiving health care through Medicaid has to work or volunteer to get coverage.

In reality, the focus-group tested, polling-approved moves are all about denying health care to people. The idea is driven by the misguided idea that people who are poor are lazy and don’t want to work.

In truth, there are real barriers to work for many of the people for whom the requirements would have applied, including a lack of training or education, lack of transportation or the need to care for a sick or disabled child or relative.

Last summer, the Kaiser Family Foundation examined four states that had implemented waivers similar to the one sought by LePage and rejected by Mills. It’s not a pretty picture.

The research found that most people who receive Medicaid and can work, already are, but the jobs they have don’t pay enough to lift them out of poverty. There’s no incentive to find work – because most folks are already punching the clock.

Instead, the requirements set up a difficult-to-navigate bureaucracy that makes it hard for some with steady, long-term employment to comply, putting their health care at risk.

Simple fact: Sick people – and those without access to health care tend to be sicker – have a hard time holding down a job.

Arkansas is one of the first states in the country to put in place these new restrictions, and the results have been terrible. Nearly 17,000 people lost access to health care.

The Indianapolis Star took a look at the horrible consequences in Arkansas and asked if Indiana might suffer the same fate: “If the experience of Arkansas is any guide, Indiana’s plan to require people on Medicaid to work could wind up creating more problems than it solves.”

The Des Moines Register also weighed in on Iowa’s exploration of so-called work requirements: “The GOP idea to add a work requirement to Medicaid is a lame justification for pursuing bad policy. It would erect a barrier for Iowans seeking health insurance, not solve the state’s labor shortage.”

And the left-leaning Center on Budget and Policy Priorities put it this way: “Medicaid work requirements can’t be fixed. Unintended consequences are inevitable result.”

Most of those losing coverage, the center found, are people who are already working or should be exempt but lose coverage because of increased red tape, bureaucracy and paperwork.

Work requirements might sound good, especially to some of the state’s more conservative voters, but Mills made the right decision to put sound policy ahead of sloganeering.

In fact, she’s taking a proactive approach to helping knock down the barriers that prevent some people on Medicaid from working. She’s directed the Maine departments of Labor and Health and Human Services to help Maine people develop the skills they need and help them to find a job.

“Ensuring that Maine people have access to health care and are healthy is the first step to getting them back into the workforce,” acting DHHS Commissioner Jeanne Lambrew said.

As can be expected, LePage – tanned, rested, ready and always eager for the microphone – weighed in on Twitter. Needless to say, he’s not a fan of Mills and her commitment to expanding access to health care.

Beyond that, it was just more blah, blah, blah from a former governor desperate to stay in the spotlight.

Once again, Mills – an accomplished political brawler in her own right – is showing that she won’t let GOP talking points or the ghost of a governor past haunt her into doing the wrong thing.

Just three weeks in, Mills is setting a high bar and showing that she heard voters when they said they wanted more health care, not less. And on that, she’s delivering.


David Farmer

About David Farmer

David Farmer is a political and media consultant in Portland, where he lives with his wife and two children. He was senior adviser to Democrat Mike Michaud’s campaign for governor and a longtime journalist. You can reach him at