By Dan Calabrese ——Bio and Archives--August 4, 2017
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When it comes to expanding Medicaid, we have been there and done that. The results 15 years ago were disastrous. The state doubled the size of its Medicaid program, but this failed to reduce the uninsured rate, emergency-room visits or uncompensated care by hospitals. We were saddled with $750 million of Medicaid debt, and I spent my first two years as governor working to repay it. By reforming Maine’s Medicaid and welfare programs, we directed resources toward the truly needy: elderly, disabled and extremely low-income Mainers. The Medicaid expansion now supported by Sens. Collins and King would open the program mostly to able-bodied people without children. These are not Maine’s most needy residents; providing them “free” health care is tantamount to giving them another welfare entitlement. Maine’s Public Law 90, a state health-reform plan that I helped implement before it was voided by ObamaCare in 2012, can be a model for the nation. The law aimed to reduce costs by allowing Mainers to purchase health insurance across state lines and created a risk pool to cover people with pre-existing conditions. Ms. Collins and Mr. King have ignored these ideas, since they are more interested in preening for the cameras than in making real progress. But I’ve repeatedly advised our congressional leaders about the key components of a successful health-care reform. First, any further Medicaid expansion under ObamaCare should be prohibited for the states that have declined it so far. Expansion would cost Maine $400 million to $500 million over the next five years, putting the state back into fiscal crisis.
Second, states should be given flexibility. The block grants outlined in the Senate’s original proposal would have moved Medicaid in the right direction, but still not far enough. Each state should have the autonomy to tailor its Medicaid program to suit the needs of its enrollees and taxpayers. Third, states should be allowed to add work requirements, increase the frequency of eligibility determinations, and reduce retroactive eligibility from 90 days to 30. This would create greater accountability for Medicaid enrollees and ensure that recipients are invested in their own health care. Given the opportunity last month to replace America’s failing health-care system with a more cost-effective plan, Sens. Collins and King instead chose to preserve the status quo while pushing an irresponsible Medicaid expansion here in Maine. Though they seem unwilling to deliver on their promises of better care, at least they have given Mainers a clear sense of their priorities.Repealing ObamaCare clearly presents a difficult problem in that the expansion of Medicaid caused a lot more people to become dependent on it, and you have to work out some way for them to transition off it. This is why I never thought it was feasible to just do a "clean repeal" with no other legislation to deal with the problems - all caused by ObamaCare itself, to be sure - that would accompany repeal. But people like Collins focus solely on the well-being of the newly minted Medicaid recipients and not at all on the problems of state-level taxpayers who have to foot the bill for the benefits. As Gov. LePage makes clear, Maine is one of a number of states whose budgets have already taken a severe hit from the Medicaid expansion. Even a number of states with Republican governors, mine included (sorry to remind you, Gov. Snyder, but it's true), were enticed by the promise of federal money to fund the expansion without really thinking through the fact that the federal share would quickly decrease and eventually go away entirely.
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Dan Calabrese’s column is distributed by HermanCain.com, which can be found at HermanCain
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