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Saturday, December 17, 2011

"Medicaid Spring" - Broken Promises and Maine's Budget Cuts

Maine's Governor LePage and his administration supports cuts to the state's Medicaid program (MaineCare) by proposing to remove 65,000 people, in a state with only 1.3 million population, from coverage. Maine Care provides the money to care for low income, mentally ill, disabled and elderly people. The 65,000 people proposed to be cut are those who are single and receiving Maine Care benefits.

In other words, the cuts will include the seriously and persistently mentally ill living in rehabilitation group homes, the homeless, the severely disabled and elderly living alone. The cuts will also remove the thousands of jobs associated with care for these vulnerable populations.

Maine Care provider groups report that Governor LePage's cuts will affect every family and every community in Maine, putting at risk the public health, public safety and the state's economy, by pulling out millions of federal dollars needed to care for the beneficiaries.  These cuts will be shifted to stretched thin charity care systems and more expensive hospital care, or, the needy people will simply go without.

Governor LePage says more Maine people receive Maine Care than the number who file income tax.

Well, sure, Maine is a poor state and the oldest state in the nation.  People are poor and old.

But here's a better fact: removing 65,000 people from Maine Care, because they're categorized as single, with little regard for their status as frail elderly, seriously disabled or mentally ill, also cuts into a margin of voters who could be enough to swing the result of any Maine election (presuming, or course, they all vote).

Not identifying who these people are, but simply writing their numbers on a flip chart for newspaper photos or television cameras, helps reinforce the idea that they're not really human beings, but just numbers that soak up Maine Care dollars.

Maine Care beneficiaries are, tragically, the brunt of one budget cut after another, a situation that stereotypes the program as somehow being wasteful.  Every time the state needs to balance the budget, the legislators and administration zero in on the largest target they can focus on - Maine Care.  The program is now cut to the absolute minimum, any more will seriously impact the quality of the programs covered.

Beneficiaries of Maine Care, on the other hand, live in a state of fear that the next letter from the Department of Health and Human Services will be the one that removes them from the program.

Moreover, average people don't understand that state's aren't alone in paying the the cost of people on Medicaid.  Federal dollars match by $3-1 the cost of the program.  In other words, if shipbuilder Bath Iron Works asked Maine for $1 tax dollar to attract $3 federal to fund building a destroyer, what do you think the response would be?  Medicaid is the same, only the $1 state dollar is spent for the poor rather than to build a defense project.

So, I say, it's time for a Medicaid Spring.  With income disparity in the US and around the world driving political unrest, and with Time Magazine's person of the year being "the protester", then it's time people who are the brunt of stereotyping to respond with their own "Spring".

Medicaid beneficiaries should take up social networking and, most important, register to vote, to remove from office, the powerful people who write numbers on flip charts to show the media how much they know, without demonstrating compassion for the people behind the numbers.    

Particularly at risk in removing 65,000 Maine Care beneficiaries are the mentally ill, who work emotionally hard with their caregivers, in supportive residential treatment programs, to achieve a level of mental wellness.  Pulling the rug out from this population by removing their group home support systems is another boot to the mentally ill, who never realized the promises made to create safe community care systems post institutionalization. But, the mentally ill are voters who need to consider this electorate power very seriously. They are among the margin of voters who can make a collective difference in the next Maine election.

In America, the metaphoric equivalent of an "Arab Spring" occurs every time we hold an election.  For those who advocate to continue cutting Maine Care, the number 65,000 written on  a flip chart can be enough to Spring you out of office.



Blogger Joe Niemczura, RN, MS said...

could not agree with you more, that pressure needs to be applied to make sure the legislture knows the terribl and tragic result of what these cutbacks will entail. Eveyr new legisaltuire it seems, needs to become educated on what the programs are about.

7:59 AM  

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