November 08, 2024
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Panel supports health program More uninsured may get Medicaid

AUGUSTA – The Legislature’s Health and Human Services Committee voted Thursday to recommend expansion of Medicaid to cover an estimated 15,000 uninsured Mainers. The recommendation was short of the 40,000 who would have been covered under the original proposal by House Speaker Michael Saxl, D-Portland.

An estimated 180,000 Mainers are without health insurance, and Saxl’s bill is considered by health care advocates to be one of the most important proposals of the session.

The committee pared down the bill during days of wrangling. Sen. John Martin, D-Eagle Lake, spearheaded a compromise plan that ultimately gained overwhelming support. The committee supported the bill by an 11-2 vote Thursday.

To get that vote the committee trimmed the program’s price tag from $47 million to $15 million and temporarily ducked the politically sensitive question of how to fund it. Funding will be discussed in the committee within two weeks or on the floor of the Legislature.

One vote seen as particularly important was that of Sen. Karl Turner, R-Cumberland. Turner, who had made a campaign promise to oppose any new taxes, ultimately signed onto the compromise bill.

Turner broke his pledge Thursday, saying it is important to offer health insurance to those vulnerable people who have incomes of less than 125 percent of the federal poverty level – the level set in the compromise legislation.

Providing coverage to more people will save society money, he said. Without coverage, individuals avoid preventive health care only to be forced to visit the emergency room for treatment that could have been avoided, he said. The more expensive emergency room cost then is shifted to those who pay insurance premiums and others, he said.

Rep. Thomas Shields, R-Auburn, who with Rep. Robert Nutting, R-Oakland, voted against the compromise, had said earlier in the week that he’s “not in favor of expanding state programs at this point.”

Medicaid is a state-federal program that covers individuals meeting certain economic and social criteria. Parents and children, for instance, are covered if they meet low-income guidelines.

Critics say the eligibility rules are flawed because they can exclude individuals who do not fall into certain categories of family relationship.

To cover such people, Saxl’s bill would broaden definitions to allow more people to enroll. The compromise bill would:

. Expand Medicaid income limits from 200 percent to 300 percent of the federal poverty level for children.

. Expand Medicaid coverage for adults not already eligible who have incomes of 125 percent of the federal poverty level or less.

. Seek a federal waiver to allow self-employed people to buy into the program.

. Expand the Elderly Low-Cost Drug Program to include cancer drugs.

Saxl’s original bill included a 47-cent increase in the tobacco tax. The revised bill would require a 15-cent increase, but even that will be a difficult sell this year, supporters said.

The Senate and the Appropriations Committee have competing budgets. The Senate’s version includes no cigarette tax increase, while the Appropriations Committee’s version includes a 26-cent increase.

Sen. Turner said that while he doesn’t like the 26-cent increase proposed by Gov. Angus King to cover the budget shortfall, he is leaning toward supporting an estimated 15-cent tax increase to support Saxl’s bill.

“What I like about it is we say here is what we’re spending it on,” Turner said.

Rep. Joseph Brooks, D-Winterport, said while he could support the bill he’d have reservations on any more taxes on cigarettes. He hears from too many constituents that another increase would be unfair, he said.

Rep. Thomas Kane, D-Saco, co-chair of the committee, said he expects that leadership and other lawmakers will agree to a combination of funding from a cigarette tax and the general fund. Whatever agreement is reached, an amendment regarding funding can be added.


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