MM Curator summary
[MM Curator Summary]: The former Governor who famously opposed expansion is running for another term.
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After once being sued for blocking voter-approved Medicaid expansion, former Gov. Paul LePage is now acknowledging that the program that provides 90,000 low-income Mainers with health care is beneficial.
However, the Republican candidate for governor, flanked by a crowd of supporters including former Second District Republican Congressman Bruce Poliquin, said Wednesday he still wants to deny more Mainers access to the health care program. LePage was at the State House submitting petition signatures to formally launch his campaign for governor.
“I’m not going to repeal anything that is good for Maine people,” LePage said in response to a question from Beacon about whether he would attempt to repeal Medicaid expansion if reelected. “I will say this, however. I will reinstate work rules. If you’re able-bodied, you need to go to work.”
Medicaid expansion, a popular part of former President Barack Obama’s Affordable Care Act (ACA) that expanded health care to people within 138% of the federal poverty line, was approved by 59% of Maine voters in a referendum in 2017.
Before the ballot measure, LePage vetoed five different pieces of legislation that attempted to tap federal ACA funding to expand the state’s Medicaid program, MaineCare.
After expansion won at the ballot box, LePage still refused to file for expansion with the federal government, prompting a lawsuit led by anti-poverty advocacy group Maine Equal Justice.
In a last ditch effort to curtail the expansion, LePage applied for a federal waiver to require non-disabled adults under 65 years old to work or attend a work program for 20 hours per week to be eligible for MaineCare coverage.
Gov. Janet Mills signed Medicaid expansion into law as her first act in office and MaineCare never adopted the work requirements.
‘We should be supporting peoples’ health care, not taking it away’
Former Gov. Paul LePage walks with supporters to the State House on Wednesday to turn petitions to run for governor. | Beacon
Robyn Merrill, executive director of Maine Equal Justice, said despite LePage’s previous efforts, Medicaid expansion has been a lifeline for thousands of Mainers.
“Thanks to the wisdom of Maine voters and the Mills administration’s commitment to implementing the law, more than 90,000 Mainers have now benefited from Medicaid expansion,” Merrill said.
“The fact that all those people can now see their doctor or fill a prescription, especially during the pandemic, has obviously been a lifeline for Maine people as well as for our economy,” she said. “Mainers have made clear, again and again, that we need more affordable health care, not less. Policies that make it harder for people to access care would take us backwards.”
It’s not clear if an attempt by LePage to curtail eligibility would be legal.
The waiver LePage submitted to the federal government in 2017 sought to impose work requirements on anyone who was 19-64 years old, unless they had a certified disability, were caring for someone with a disability, or caring for a child under 6. Those individuals would have to engage in 20 hours or more each week of employment or education, or 24 hours of community service.
James Myall, a policy analyst with Maine Center for Economic Policy, estimates that roughly 86,000 Mainers currently enrolled in MaineCare would be subject to the requirement if similar mandates were imposed and as many as 55,000 of those people would be at risk of losing their health care — roughly one in seven people currently enrolled.
Myall said that estimate includes individuals who are working but unable to meet the 20-hour weekly requirement.
However, it’s not clear if LePage, if elected, would have the authority to impose such restrictions. Last year, the Centers for Medicare and Medicaid Services under President Joe Biden began withdrawing permission for states to impose the requirement. Also, work requirements have been successfully challenged in the courts, including the D.C. Circuit Court of Appeals in a case that has been shelved by the U.S. Supreme Court.
Myall warned that status “could change if we have a change in presidential leadership, and it’s not clear to me what the current Supreme Court would do if this made its way through the courts.”
He added, “So while LePage’s proposal isn’t realistic right now, it’s still a threat in the future.”
Both Merrill and Myall say the COVID-19 pandemic has underscored how imposing barriers to health care access harm whole communities and economies.
“When they passed Medicaid expansion, Maine voters knew that it would allow more people to be healthy and be a part of their communities and the workforce,” Merrill said. “Today, the pandemic has made it even more clear that you should not tie access to health care to employment. These kinds of conditions for care don’t work — and if the goal is really to help people to get and keep a job, then we should be supporting peoples’ health care, not taking it away.”
Myall agreed that the pandemic “really drove home how important it is for everyone to have access to affordable health care, and that’s especially true for people who can’t find work, or are only able to work part-time.”
A record of restrictions
LePage’s comments Wednesday targeting “able-bodied” Mainers echoed similar rhetoric the former governor and other Republicans have used against those deemed undeserving of support.
During his eight years in office, LePage worked to restrict access to health care and other anti-poverty programs like food assistance and Temporary Assistance for Needy Families (TANF).
In 2014, he mandated work requirements for childless adults ages 18 to 49 who used the federal Supplemental Nutrition Assistance Program, formerly known as food stamps. SNAP recipients fell from 227,666 in 2014 to 169,638 in 2018 and more Mainers went hungry than the rest of New England and much of the country.
One 2017 survey by the Good Shepherd Food Bank found that over half of the people who were cut off due to work requirements were looking for work but couldn’t find any. More than three-quarters reported increased visits to the food pantry in the year they lost benefits.
Top photo: Former Gov. Paul LePage speaks to the media on Wednesday. | Beacon