The following article by Barbara Leonard and Dr. Connie Adler originally appeared in the May 18, 2014 edition of the Lewiston Sun Journal:
By Barbara Leonard and Dr. Connie Adler
The legislative session recently concluded, and at the end it was decided to leave 32,000 Maine people without access to health insurance coverage because lawmakers did not expand MaineCare, Maine’s Medicaid program. Whether people agree with the decision or not, it is important to understand the impact it will have in this state.
A week after the end of the session, results of a new study show what Maine’s future could be. A Harvard study published in the May 5 issue of "Annals of Internal Medicine" showed that Massachusetts’ 2006 health reform law, which has resulted in near-universal health insurance coverage for its residents, has significantly reduced the state’s death rate. In the four years since the law passed, mortality decreased by 2.9 percent. That means that for every 830 people who gained coverage, one life was saved.
What is most striking is that the study showed the benefits of expanding coverage were greatest in counties with lower incomes and with more uninsured people before the new law went into place.
Low income and uninsured — that sounds a lot like the population eligible for coverage under the MaineCare expansion that Maine failed to implement.
So let’s go back to the 32,000 Mainers without access to health insurance. Many work for themselves, or make very little at seasonal or multiple part-time jobs, or are unemployed — many due to the recession. Instead of being able to see their doctor for preventive care or a minor illness, they end up in emergency rooms or admitted to hospitals where they will run up large bills they cannot repay. That means they burden themselves and hospitals with debt, threatening their own future and the financial stability of Maine’s hospitals.
It also means that 39 Maine people may pay with their lives, if the results from Massachusetts hold true in Maine.
Medicaid expansion was intended to be a cornerstone of the Affordable Care Act, aimed at providing coverage for the poorest among us. For that group, there are no other options. And the federal dollars that would have paid for their coverage through MaineCare are left sitting on the table in Washington, D.C.
Non-partisan health policy experts and academics reviewed the results of the Massachusetts study and praised the quality of the research. Sadly, one also commented on the “natural experiment” that will demonstrate the impact of not having health insurance for people in states such as Maine that chose to not expand Medicaid. This researcher noted that the situation is “unfortunate” for those who live in those states.
Let’s not have Maine people be the “unfortunate” subjects in a real-life health insurance experiment. It’s just not right.
Barbara A. Leonard, MPH, is vice president for Programs at the Maine Health Access Foundation in Augusta, Maine’s largest private, nonprofit foundation dedicated to health care.
Connie Adler, MD, FAAFP, is lead physician at Franklin Health Women’s Care, secretary of the board of directors of Franklin Memorial Hospital in Farmington, and a member of MeHAF’s board of trustees.
Note: An abstract of the Annals of Internal Medicine study referenced in the article above,"Changes in Mortality After Massachusetts Health Care Reform: A Quasi-experimental Study," can be found here.
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