Maine Writer

Its about people and issues I care about.

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Location: Topsham, MAINE, United States

My blogs are dedicated to the issues I care about. Thank you to all who take the time to read something I've written.

Saturday, May 09, 2020

A bad repeat - "I was Donald Trump before Donald Trump" a nightmarish groundhog day

https://www.nytimes.com/2016/09/01/opinion/before-donald-trump-gov-paul-lepage-of-maine.html

...if the movie "Groundhog Day" were a horror flick, this is what the plot would include....

In my Maine Writer opinion, this archived echo "letter to the editor", (scroll down) published in the New York Times on August 31, 2016, was a dire premonition that became a nightmarish reality. Maine citizens, like me, fell victim to the wrong minded idea that Governor Paul LePage would never be able to become the governor of the state where Senator Margaret Chase Smith, Senator George Mitchell and Governor Muskie had been iconic leaders.

Now, here we are in another "groundhog day" nightmare kind of year and the story is seriously not fiction. This letter, published in 2016, can too easily apply to 2020.  Indeed, the premonition warnings of 2016 must resurface! 

If it can happen in Maine, and it did....a nightmarish embarrassment after eight years....it can happen to Americans.

"As Maine goes" (so goes the nation?) is too horrendous a concept to fathom, but we must acknowledge this possibility or, like those who ignore history, it will infect us again.  Unbelievably, Governor Paul LePage wants to run again to reclaim the office where he was term limited out.  It's hard to understand this egotistic political behavior, especially when the current attitudes towards Republican Susan Collins and her cohort Donald Trump are ambiguous at best, and disdained by a growing number of Mainers. 
Governor Paul LePage survived wave after wave of controversies. (Michael Dwyer/Associated Press photo)
A prophesy to be aware of: To the Editor of the New York Times:

Re "How Controversial Is Maine's Governor? Here's a Partial List" (by Jess Bidgood) (news article, Aug. 30):

So how did Maine, known for bipartisanship and civility in civic life, twice put Gov. Paul LePage in office? Here is a partial list.

A third-party candidate, Eliot Cutler, who twice (in 2010 and 2014) convinced a significant portion of the electorate that "voting their conscience" could flip the election in his favor. Some people never learn.

Republican leaders and voters who, putting party loyalty above common sense, reliably worked to put a good face on Mr. LePage's bad behavior. Some people should know better.

Columnists and commentators who were so amused by Mr. LePage's style that they failed to take seriously the threat he posed and the damage he was doing. Some people were not paying attention.

Does this perfect storm of self-indulgence and media and public complicity sound familiar? Our term-limited governor has said, "I was Donald Trump before Donald Trump became popular," and I heard him say in a call-in show that he'd be interested in a Washington appointment with a golden parachute. Watch out, America, Paul LePage - and a dangerous repeat- may be coming your way.

Annlinn Kruger  Bar Harbor, Maine

P.S. Maine Writer - Thank you Annlinn Kruger!

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Monday, December 03, 2018

Jobs site for unemployed Republican governors- Walker and LePage

This opinion letter was published in the Kenosha News, a Wisconsin newspaper.  The premise of this opinion is excellent; so I'm thinking to compose a similar letter to apply to outgoing Maine governor Paul Lepage.

Job recommendation for the Wisconsin lame duck Governor Walker: "Seek appointment in Trump’s cabinet. (Oops, Trump doesn’t like “losers.”)"

How ironic that Wisconsin's self professed “education governor” got beat by a school teacher. 

Wisconsin Trump loyalists must be cringing. As Wisconsin's lame duck governor Walker ponders his future, here are a few job suggestions for his potential employment:

1. Return to Marquette University, finish his degree, improve his job marketability skills, and quit being a “fake alumnus.”

2. Enroll in Trump University.

3. Seek appointment in Trump’s cabinet. (Oops, Trump doesn’t like “losers.”)

4. Assembly line worker in Ivanka Trump’s foreign factory.

5. Staff security guard shack for Uline Corp (at the company's expansion site).

6. Shoe shine attendant and valet for the Koch brothers.

7. Crying towel salesman for the Wisconsin Republican Party.

8. Maintenance worker for the Foxconn housing village.

9. Ron Johnson re-election campaign director.

(MaineWriter: What about being a farm worker supervisor for the harvesters in the Kenosha County Wisconsin Farm Bureau?)

Given that Scott Walker has never had a real job that did not provide him with a taxpayer-funded salary, health insurance, pension, limos, airplanes, expense accounts, etc., perhaps he can now avail himself to one of the 250,000 jobs he promised us. Kimberly-Clark is hiring.

Richard A. Bosanko, Bristol, Wisconsin

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Thursday, October 18, 2018

Maine Medicaid was poorly served under Mary Mayhew

Severe cuts to the Medicaid budget led to staff shortages and, as a result, vulnerable children were at risk for abuse.  Sadly, we only know about the people who suffered and didn't hear from those who did not report their adverse incidents.  Now, Mary Mayhew will bring her do nothing style of care to Washington.  God please spare Americans the outcome of her Medicaid oversight.
Mary Mayhew was a cruel DHHS Commissioner in Maine but Maine Writer suspects that she and Kellyanne Conway (aka, Cruella de Vil) will get along great. 
This report in Rewire.News is by Katelyn Burns

The Trump administration announced the appointment Monday of Mary Mayhew, the former Maine commissioner of Health and Human Services, to head the federal Medicaid program. The decision shocked Maine residents and health care advocates who pointed to Mayhew’s long history of advocating for and executing deep cuts in social safety net programs and her opposition to expanding Medicaid access in the state.

“From the perspective of someone who thinks that we should be providing people with more health care, not less, it’s hard to imagine someone less suited for this job than former commissioner Mayhew,” said David Farmer, former communications director for Mainers for Healthcare, in an interview with Rewire.News. Mainers for Health Care ran a successful ballot initiative last year to expand Medicaid in the state under the Affordable Care Act, but the expansion has since been stonewalled by Republican Gov. Paul LePage.

“I can’t imagine anyone who would bring the same mix of ideological cruelty and history of mismanagement to a high-level job like this,” Farmer said. “The only way that Mary Mayhew would be a candidate for this position is if your goal is to dismantle the Medicaid program.”


Mayhew, who ran Maine’s Department of Health and Human Services (DHHS) until May 2017, finished a distant third in the state’s Republican primary for governor. 

Under Paul LePage—a vocal opponent of Medicaid expansion who has continuously blocked its implementation in the state—she oversaw massive cuts to programs like Medicaid and food stamps. “She’s not just hostile to Medicaid; when she was part of Governor LePage’s administration in Maine, she was front and center in that administration’s quest to burn down pretty much the entirety of the social safety net,” said Rebecca Vallas, vice president of the Poverty to Prosperity program at the Center for American Progress. “She was a vocal proponent of taking nutrition assistance through food stamps away from people who were trying to find work or couldn’t get enough hours at their job.”

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Friday, May 25, 2018

Maine Equal Justice ~ MEJP ~ in court to support Medicaid Expansion



Dear Juliana,

Yesterday was a great day in court for Medicaid expansion. 

As you may know, the Mainers for Health Care legal team, led by Maine Equal Justice, our allies, and Mainers who are among the 70,000 newly eligible for care filed suit against the LePage administration for its failure to implement the voter-approved Medicaid expansion law. 

(If you missed it, watch our "See you in Court, Governor" video here.)

Yesterday, oral arguments in the case were heard in Cumberland County Superior Court. 

MEJP's Jack Comart and Tina Nadeau were live outside the courtroom yesterday morning--watch the video here.

As Maine Public reported, MEJP lead attorney Jamie Kilbreth argued that the LePage administration has a simple duty to uphold the law voters passed:

Kilbreth told Judge Murphy that the LePage administration was using the legislative stalemate over funding to procedurally veto a voter-approved law. "What this is all about is a backdoor attempt to do what the Constitution prohibits the governor from doing," he said. "The court should not enable that kind of behavior."

Kilbreth added that LePage has been a vociferous opponent of Medicaid expansion, vetoing legislative proposals nearly a half dozen times after pitched battles in the Legislature. Kilbreth says the law voters approved in November is clear: Medicaid expansion is the law and the governor's administration has to implement it.

This case continues to draw national attention because Maine is an example to other states working to pass expansion ballot initiatives. Because of your hard work and perseverance, nothing will stop us from seeing this fight for health care through to its finish when 70,000 Mainers finally get the coverage they need. We’ve taken the fight to the courts, we’ll be back in the legislature when the opportunity arises, and we’ll continue to raise our voices together in this effort and beyond. We’ve waited too long. The time is now!

What's next?


We expect a decision in the case in the next few weeks, though appeals may take longer. 

 MEJP and Mainers for Health Care will continue to work to implement the law and the will of Maine voters, whether in the courts or in the state house! Thousands of Maine people are counting down to health care, which shouldbecome available to them on July 2nd. That's why we are currently building a team of volunteers available to support those eligible for Medicaid Expansion so people know the process and their rights come July 2nd. It's time we assert our right to care.

--> Can you help? Sign up here to volunteer on our Medicaid Expansion outreach team!<-- br="">
We deeply appreciate all of your efforts on behalf of Mainers who need affordable access to care.

Wishing you a restful long weekend,

Kate Brennan, on behalf of Mainers for Health Care

P.S. Please help us support those who do have a right to apply for health care starting July 2nd. It is critical that people assert their rights in this way. Can you help? Sign up here to volunteer on our Medicaid Expansion outreach team!

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Tuesday, April 03, 2018

Medicaid Expansion ~ Maine people speak in Augusta State House April 3, 2018

A press conference held jointly by Maine Providers Standing Up for Healthcare with Maine Equal Justice Partners.

AUGUSTA, ME ~ The purpose of the April 3, 2018 press conference was to educate the public about demanding the Governor Paul LePage administration's due compliance with the Medicaid Expansion law.

Donna Walls (right) at the April 3, 2018 press conference with Maine Providers Standing Up for Healthcare, pictured with Allison Weiss, in Augusta Maine
Maine lawmakers, five times, passed the Medicaid Expansion as provided under the Affordable Care Act.  Each time, the bill was vetoed by Maine Governor Paul LePage. Subsequently, in November 2017, the Medicaid Expansion was passed by ballot initiative.

Today in Augusta, Maine, the providers and Maine citizens demanded for the Governor LePage administration to comply with the law and to support the law passed by voters.

Donna Wall described the circumstances she is challenged since her Medicaid coverage was revoked by Governor Paul LePage.

Press conference attendees were visibly moved by Donna Wall's dire situation:

My name is Donna Wall and I'm a member of the Lewiston community.  I am one of the thousands of uninsured Mainers who are struggling with medical debt and worried about my future.

I am a full time, unpaid caregiver for my three adult kids living with autism.  When my two sons turned 18 years old, almost two years ago, I lost MaineCare eligibility and I've been uninsured ever since.  I'm here speaking today to show my support for caregivers and the medical providers who work so hard to take care of our kids, elders and loved ones. Medical providers see, first hand, what happens when their patients are uninsured and I thank them for speaking up with me today.

Over the past few months, I have been reminded of just how important health care is.  Although I already work full-time as an unpaid caregiver, I needed to find paid work to support my kids and I managed to find a job that fit my busy schedule. 

At 2 AM, after my kids were long asleep, I delivered newspapers door-to-door.  If I ran, the four-mile route could take me three hours.  If the weather was bad, it could take me close to five or six hours.  The long, cold Maine winters were the worst because of the icy conditions.  Last year, I fell and injured my tailbone and rib.  

I didn't go to the hospital because I knew I couldn't afford the bill.

This past December, while on my newspaper route, I slipped and fella gain.  This time, I was left with more than a bruise. I broke every bone in my ankle. I had no way of avoiding going to the hospital, this time. It was devastating when the emergency room doctor told me I needed surgery.  All I could do was think about who was going to care for my kids and how I was going to pay for my medical treatment.

To date, I am $62,000 in medical debt. Knowing that Medicaid expansion is the law and will be implemented on July 2nd is a huge relief for me and my family. I will no longer have to fear going outside and getting hurt and being burdened with more debt. I can focus on caring for my kids.

Governor LePage said he will not implement the Medicaid expansion law until the wait lists for home care services are funded.

Well, I am living proof that this is a false choice that we do not need to make. My children are on the wait list for section 21 services AND I need health care under the expansion, so that I can continue to care for them.

Both issues can be priorities. With revenue surplus of $140 million, the Governor could propose to fund Medicaid expansion and reduce the wait list for home care services. The governor is creating a false choice and attempting to pit people against one another, but we are all in this together and Maine can do better than that. 

The truth is, that Governor LePage is choosing to prioritize tax breaks for corporations and wealthy ahead of providing affordable health care for all Mainers. 

I am calling on the Governor and the Legislature to ensure that Medical expansion is funded so that people like me can get the health care they need. 

We're counting the days; we're counting on you.

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Tuesday, March 27, 2018

Maine Medicaid Expansion - echo opinion

Maine Voices: Medicaid can do so much for Mainers, why does the governor resist expansion?


It would support families, save lives, improve health, create jobs – and to cap it all off, it's a huge bargain.

Dr. Sam Zager, ~ PORTLAND, Me ~ I wish I could introduce one of my patients to Gov. Paul LePage.


This patient is a young man whose situation illustrates how Medicaid can pay huge dividends for individuals, families, communities and the state. He became my primary-care patient last fall, soon after his visit to an emergency department for physical trauma.

Besides dealing with this immediate concern, he and I also talked about his substance abuse problem. Somewhere between his prison time and seeing the havoc of the opioid crisis all around him, he understood he needed help. His low-wage job doesn’t include health insurance, but fortunately, he has it through Medicaid.

The expansion of Medicaid – also known as MaineCare – would extend such benefits to over 70,000 other Mainers like this young man, at a net cost to the state of $62 million. In other words, the state annually would effectively pay a mere $867 per person for health insurance – an incredible bargain.

Nearly two-thirds of states have capitalized on this deal. Expansion states cover people with income up to 138 percent of the federal poverty level ($16,753 annually for an individual; $34,638 for a family of four). Every other state in New England has expanded Medicaid, which has yielded them better than 9-to-1 matching funds from the federal government. The Maine Legislature has approved expansion of Medicaid five times in recent years. Each time, Gov. LePage vetoed it. Then last November, Maine voters took the veto-proof step of passing a Medicaid expansion referendum by a wide margin: 59 percent to 41 percent.

By law, Gov. LePage’s administration now has until April 3 to submit an expansion plan to the federal government. Unfortunately, he has given every indication that he will not do so.

Frugality has its place, but Maine already has the necessary money to invest. Earlier this month, the state’s Revenue Forecasting Committee affirmed that for each of the next four years there would be $180 million to $190 million of unappropriated revenue. There also are hundreds of millions of dollars in Maine’s Medicaid fund, even though Maine already forfeited tens of millions of dollars by not expanding Medicaid earlier, when the federal government was paying the entire expansion cost.

Despite that low state cost, the benefits would be profound.

• For starters, health insurance saves lives. The best estimates from the medical literature – presented by Harvard health economists in studies published in 2014 and 2017 – suggest that expanding coverage would save around 140 lives each year in Maine.

• Second, quality-of-life, chronic illness and other non-mortality outcomes significantly improve when people have health insurance, the Harvard researchers concluded last year in a separate article.

• Third, healthier people contribute to healthier families and more vibrant, prosperous communities.

• Finally, expansion would infuse Maine’s economy with hundreds of millions of dollars annually. In a report released last September, Maine-based health economist Elizabeth Kilbreth estimated that expansion would generate about 6,000 permanent jobs in the state, spread across the health and non-health sectors. Some of those jobs would help keep critical-access hospitals, departments and clinics open, which is a major concern in the vast rural Maine landscape.

The comprehensive, Medicaid-funded primary care to which my patient has access gives him much more than a fighting chance to have a fulfilling and productive life. Now, his injury has healed; he remains sober from opioids, with the help of Suboxone (the brand name for buprenorphine); he is quitting smoking; he has been exercising more; and he is working full-time.

I asked him recently to reflect on his personal journey. He told me that things have gotten much better since getting care. “(I’m) workin’ a full-time job, payin’ taxes, payin’ my fines off, helpin’ my parents pay for their house, savin’ up for a basic car,” he told me.

And then his thoughts turned to his school-aged daughter: “Since I’ve been here, I’ve gotten a lot closer with her, thinking about her. I used to just want to get high, and spend all my money on that, but that’s not ruling me now. (Instead, my daughter) wants to hang out with me all the time, so I think I’m doing all right by her.”

This young man is not simply a Medicaid recipient; he is the anchor of his family. He knows the dignity of both an honest day’s work and having health care. Why won’t Maine’s governor expand Medicaid and guide over 70,000 more Mainers and their families in the direction of health?

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Monday, March 19, 2018

The Times Record in Maine ~ Medicaid Expansion opinion

My letter to the editor ~ Thank you to The Times Record in Brunswick and Mid Coast Maine for publishing my letter to the editor in support of the voters who approved the Medicaid Expansion* in November 2017, by ballot initiative.

LETTERS

Time for LePage to Comply with Will of the Voters

Maine voters approved the expansion of Medicaid with a 58.9 percent approval in the November 2017 election, but the Maine Department of Health and Human Services must provide a plan to the Centers for Medicare and Medicaid Services to begin offering this coverage to the qualified beneficiaries. Moreover, in the past, Maine’s legislature has five times passed the Medicaid expansion as provided under the Affordable Care Act, but Gov. LePage used his veto power to prevent the bills from becoming law. There are at least 70,000 Mainers who are qualified for the expanded Medicaid expansion coverage.

It’s time for the Maine DHHS and LePage to comply with the will of Maine’s citizens and submit the necessary plan to the CMS for approval, by early April. This submission is necessary before the coverage can be offered. Compliance with the will of the voters could make the Medicaid expansion possible, as soon as July 2018, but only if the necessary requirements are sent by the Maine DHHS for approval. Maine Providers Standing Up for Healthcare is a grass roots organization working with the Maine Equal Justice Partners and other advocacy groups, to ask the Maine DHHS to comply with the will of our citizens, and submit the request to CMS for the expansion, so as to cover those who qualify, as soon as possible.

Juliana L’Heureux,
Topsham

*One of the most important--and popular--provisions of the Affordable Care Act (ACA) is the expansion of health coverage to low-income families through the Medicaid program. In the 33 states (including D.C.) that expanded Medicaid, many of those who benefit are hard-working people in low-wage jobs that do not offer health insurance—like waiters and waitresses, sales clerks, cooks, and home health aides

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Friday, December 29, 2017

Republicans and poverty

Maine Equal Justice Partners published this disturbing report about how Maine is not sharing in American prosperity.  After reading and now blogging this narrative, it makes even less sense for Senator Susan Collins to have wrongly supported the Republican bill to give tax cuts to the rich.  Nothing in the Republican tax cuts for the rich will improve the quality of life for the people who are described in this report:  


Maine is not sharing in the prosperity being experienced by rising socio-economic data, reported in other US states. 

Yet, Maine's Republican Governor Paul LePage, the Second District Congressman, and Republican Bruce Poliquin and Senator Susan Collins, a Republican from Caribou, Maine, are not responding to the state's poverty problem. 

Instead, they supported the Republican plan to provide tax cuts for the rich, the people who are already prospering in the US economy, rather than invest in programs to improve Maine's economy to the level of prosperity, like what's happening in other states.

This report from Maine Equal Justice Partners:

Maine is not sharing in the progress being made in other parts of the country; in fact, it has been heading in the wrong direction for the past several years. 

Significant cuts to Maine services have left thousands of Mainers behind. And actions of the Republicans in Congress and the Trump administration threaten to push even more Maine people into poverty. Data released in September by the Census Bureau show that the national poverty rate declined from 2015 to 2016. 

Additional data from the Census Bureau and other sources show the ways the U.S. is making progress in the fight against poverty. We are seeing relief for families who have been lifted out of poverty by an increase in incomes and the number of jobs brought on by a stronger economy as well as by federal programs and policies that lift them up. 

In fact, the new Census Bureau data also shows that effective anti-poverty programs like housing assistance, Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program, (SNAP, formerly known as food stamps), low income tax credits, and assistance for people with disabilities have lifted millions out of poverty. Yet, while the nation is making progress in poverty reduction, that same progress is not being shared in Maine, where poverty rates remained flat from 2015 to 2016

Through so-called “welfare reforms,” Maine’s Governor LePage and other policy makers have significantly diminished the state’s anti-poverty programs in recent years thus, they are not working as well as they could to deliver opportunities and lift families out of poverty. Compared to 2011, an estimated 100,000 fewer people receive assistance for food, shelter, or medical care here in Maine.

And proposals from Congress and the Trump administration to cut programs that have lifted millions out of poverty threaten even more vulnerable people. Proposed budgets and spending bills from leadership in the House, Senate, and White House would slash billions from the very programs that are designed to support low-income Mainers. Such cuts would surely cause more Americans and more Mainers to suffer in poverty and near poverty. 


The State of Poverty in Maine 

Roughly 161,750 Mainers (12.5 percent) are suffering under poverty’s weight. Approximately 59,000 Mainers (4.5 percent) live in deep poverty – less than $800 a month for a family of three. 3 This includes nearly 16,400 Maine children. 

Tragically, children remain more likely to be poor in America than any other age group, with nearly one in five in poverty nationwide. 

Although there has been some progress in reducing both child poverty and deep child poverty in the U.S. – this progress is not shared by Maine kids. In fact, since 2011, the proportion of U.S. children living in deep poverty decreased by 4.2 percent, while it increased in Maine by 13.6 percent.  The rate of child poverty nationally has dropped in the last year, while it remains stagnant in Maine, standing at 17.2 percent in 2016, showing no improvement
from 2015 levels.

Communities of color in Maine saw a lack of progress in poverty reduction as well: 42.7 percent of African Americans and 17.9 percent of Latinos were poor in 2016, percentages comparable to those in 2015 and 2007. 


In contrast, the poverty rate among non-Hispanic whites in Maine in 2016 was 11.5 percent. In Maine and in the nation as a whole, communities of color still remain disproportionately affected by poverty. The number of American households that are food insecure has continued a downward trend nationwide, but here too, progress eludes Maine families. The proportion of American households that weren’t always able to provide enough food for all family members in 2016 is down 12 percent from 2014 and down 17 percent from a high in 2011.5 

Hunger has decreased in the region and the rest of the nation, but not so in Maine. Here, on average 16.4 percent of households were food insecure between 2014 and 2016,—26 percent higher than the national average. This is statistically flat from 2011-2013 and remains 3.5 percentage points higher than pre-recession levels. 

Due to program changes such as an ineffective work requirement and a burdensome new asset limit, roughly 42,600 Mainers lost food assistance from 2011-2016,6 and Maine has the third highest rate of very low food security in the nation. 

Mainers in rural areas face particularly high barriers to getting the food they need. 

Across the country, progress has been made in increasing the number of Americans with health insurance, thanks to health insurance subsidies available under the Affordable Care Act and the states’ option under the law to use federal dollars available to them to expand Medicaid coverage to low income adults. 

Nationwide uninsured rates fell 41 percent from 2013 to 2016. But in Maine, which had not yet expanded Medicaid coverage, uninsured rates were flat from 2015 to 2016, and declined only 29 percent from 2013 to 2016. 

In other words, Maine saw some gains as individuals gained access to subsidized insurance on the Marketplace, but did not benefit as did other states from Medicaid expansion. Even more troubling, due to so-called “welfare reforms” championed by Maine’s Governor, Paul LePage, between 2011 and 2016, more than 40,000 Mainers lost their health insurance through MaineCare and the Elderly Drug Program including seniors, children, working parents, adults under the 3 poverty level, and immigrants. 

Maine’s overall health ranking during that period fell from 10th best in the nation to 22nd , showing that Maine has been heading in the wrong direction. In November 2017, however, Maine voters chose by ballot initiative to expand the state’s Medicaid program, making Maine the first state in the nation to make that decision through an election measure. The impetus for voters to do this came about after Maine’s legislature passed Medicaid expansion five times, only in each case to be met by a veto from Governor LePage. Now, with over 59 percent of voters approving the measure at the ballot this November, an estimated 70,000-80,000 people will begin to finally receive the coverage that they need.

Effective Programs Reduce Poverty and Speed Up Progress 

The Census Bureau’s Supplemental Poverty Measure (SPM) is a more accurate measure of poverty and its changes over time than the official poverty rate noted above. This is so because, unlike the official poverty rate, the SPM counts income sources such as federal tax credits and food and housing assistance as well as expenses like out-of-pocket medical costs. The SPM shows that federal programs increase incomes for millions of Americans, lifting them out of poverty and reducing the burdens of poverty for millions more. After accounting for under-reporting of benefits, safety net programs were shown to have lifted 46 million Americans, including 12 million children, out of poverty each year between 2009 and 2012, on average. 

In Maine, (a) 240,000 people, including 42,000 children, were lifted out of poverty by basic living standard programs each year between 2009 and 2012, on average (b) Supplemental Security Income (SSI), federal support for people with very limited resources who are elderly or with disabilities, or families caring for children with severe disabilities, lifted 24,000 out of poverty (c) 16,000 fewer people were poor because of housing subsidies; (d) 47,000 fewer people were poor because of SNAP (Food Stamps) (e) Low-income tax credits lifted 28,000 out of poverty each year between 2011-2013, on average (f) Nationally, more than 8.1 million people were lifted out of poverty by low-income refundable tax credits in 2016; (g) 3.1 million fewer were poor because of housing subsidies and (h) 3.6 million fewer people were poor because of the Supplemental Nutrition Assistance Program (i) SSI lifted 3.4 million people out of poverty, and (j) the school lunch program did the same for 1.3 million people. 

The Census data shows that 10.5 million more people would be in poverty if out-of-pocket medical costs were taken into account, showing the importance of quality, affordable health insurance.

In fact, programs that help provide basic living standards play a major – and increasingly important – role in the reduction of poverty that has occurred since the 1960s. 

Researchers using the Supplemental Poverty Measure and other data, including adjusting poverty thresholds for costs of living and different housing situations, found that poverty has actually decreased by more than one-third since 1967. According to this analysis, 13 government programs reduced the national poverty rate by 12.0 percentage points in 2014 and lifted more than 50 million people above the SPM poverty line that year. In Maine, the poverty rate would have been 14.6 percentage points, higher in 2014, without government programs; child poverty would have been 12.5 percentage points higher, and poverty among the elderly would have been 42.2 percentage points higher in 2014, without these programs.

Programs that help Maine people to achieve basic living standards do more than lift people out of poverty. Medicaid allows low-income individuals to address health issues and live healthier and more productive lives, even improving health outcomes across generations. A recent study found that the grown children of women who had received Medicaid during their pregnancies were more likely to have healthier babies. 

Housing vouchers sharply reduce housing instability and homelessness, as well as other hardships like food insecurity, domestic violence and child separation, for recipients, 68 percent of whom are seniors, children, or people with disabilities. SNAP is our nation’s largest child nutrition program – one in four children in the U.S. lives in families that receive SNAP benefits. SNAP improves the health and educational outcomes of children in the near- and long-term and improves the health of their parents. 

Families participating in SNAP are also 28 percent more likely to be able to pay for medical expenses without forgoing basic necessities like food, rent and utilities. In addition, SNAP is an economy booster: economists estimate that in a weak economy, $1 in SNAP benefits expands the economy by about $1.70.18 In a recent survey in Maine, nearly half of respondents said they would go hungry without SNAP.19 Federal and state assistance programs also help people get and keep good jobs. 

Child care subsidies, for example, allow parents to go to work or school and provide children with quality educational experiences in the critical early years. Single mothers were more likely to be employed, more likely to be employed full time, and more likely to have stable employment when receiving child care subsidies.

Unfortunately, many of these effective anti-poverty programs do not reach enough of the people they are designed to help. The Temporary Assistance for Needy Families program was designed to help families meet their most basic needs and provide employment, education and training services for low-income parents. But the number of Maine families receiving cash benefits through TANF has dropped 66 percent since May 2012, when a state-imposed five-year lifetime cap on benefits took effect.

Two-thirds of people in Maine who lost benefits as a result of the cap still didn’t have work four years after the cap took effect, leaving most families without cash assistance or earnings from employment. And the third who did work were not earning enough to make ends meet.

All told, roughly 9,000 Maine families, including 16,000 children, lost help from the TANF program between 2011-2016.23 More than 28 million Americans, including 106,000 Mainers, remain uninsured. Low-income adults in the states that refused to expand access to Medicaid to their low-income residents are uninsured at nearly twice the rates of those in states that have taken this step to expand coverage, leaving them at even greater risk for overwhelming medical costs and, too often, forcing them to forgo necessary medical treatments. 

The lack of child care holds back working parents. Only one out of seven children eligible to receive federal child care assistance is getting any help, and more than 373,000 children in need have lost access to child care since 2006, including 2,600 children in Maine, leaving families to struggle to pay for care or forgo jobs to stay home and provide care. 

Nationally, only one in four qualifying renters receives rental assistance because Congress has not provided enough funding.

Between 2004 and 2015, the number of families with children receiving rental vouchers dropped by 250,000 – a 13 percent decline. This is despite the fact that the Census 5 data show that 45 percent of Maine households with income less than $20,000 a year spend more than half of their income on housing. The Earned Income Tax Credit (EITC), an extremely effective anti-poverty and pro-work tax credit, provides far less help to low-income workers who aren’t raising children. This group has an unenviable distinction as the only group of Americans who are taxed into poverty. 

Expanding the EITC to these workers would benefit up to 16.2 million people.

Similarly, families with children earning less than $3,000 a year are excluded from claiming the Child Tax Credit (CTC), denying help to children because their parents, despite working, are too poor. Expanding the CTC to these poorest children and families would benefit millions every year. As noted above, Maine’s Governor and policy makers have instituted changes in recent years that have further limited access to anti-poverty programs in our state. We know that there are approximately 100,000 fewer people receiving help from assistance programs in our state than did in 2011, when most of these policy changes began. This could include tens of thousands who would have been lifted out of poverty had those changes not been made. The Trump Administration and Congress Would Make Maine Poorer Proposals from President Trump and leadership in Congress to cut successful anti-poverty programs like Medicaid, SNAP, housing assistance, and others would harm individuals and families and would turn back the progress we’ve made in reducing poverty. 

For example, the House and Senate passed a joint FY 2018 Budget Resolution that calls for about $5 trillion dollars in cuts through 2027 to the full range of services the federal government provides, except for allowing increases in military spending. It would cut Medicaid, the Affordable Care Act (ACA), and other health programs by $1.3 trillion over that ten-year period. Medicare would be cut by $473 billion. Programs in the “income security” category (which includes SNAP/food stamps, Supplemental Security Income for poor seniors and people with disabilities, Temporary Assistance for Needy Families, unemployment insurance and low-income tax credits) would drop by $653 billion. The Senate plan calls for $800 billion in cuts to domestic appropriations, threatening further cuts to housing, education, and substance abuse treatment, to name just a few. By 2027, the Senate budget would slash these programs to 29 percent below their levels in FY 2010, taking inflation into account. 

If these cuts are made proportionally, by 2027, 900,000 low-income households would lose their rent subsidies,  despite their success in lifting millions of families out of poverty. 

Even with the ACA remaining in place, the Trump administration has announced it will allow inadequate insurance plans that do not assure protections for people with pre-existing conditions or expensive medical needs. The administration will stop making payments to insurance companies for low-income policy-holders, all aimed at further weakening the law. In addition, the Trump administration has been undermining the ACA by refusing to advertise open enrollment or to approve requests by states to improve their programs. 

These actions, plus unspecified Medicaid and ACA cuts in the budget, can significantly undo the progress made in reducing the number of uninsured Mainers by 41,000 since 2013 and threaten the impact of Maine’s newly voter-enacted Medicaid expansion law. While not all of the cuts in the budget are expected to become law, they show the vision of the House and Senate leadership – to drastically reduce critical programs for low-income families. 

Cuts in President Trump’s budget are extremely harsh, including $4.3 trillion in cuts to Social Security, Medicare, Medicaid, education, and other programs and services that help working families get by and get ahead. 

If just three of President Trump’s proposed budget cuts had been in effect in 2015, an additional 2.3 million Americans would have been in poverty that year. 

In addition to these threats, passage of the budget resolution will allow Congress to use special rules known as reconciliation to fast-track huge tax cuts for the wealthy and corporations, and perhaps to expedite cuts to safety net programs as well, and to do so with only a simple majority in the Senate.

The budget will allow Congress to increase the deficit by $1.5 trillion over 10 years to give tax cuts to those with the highest incomes. The loss of this revenue will inevitably hurt low- and middle-income Americans, both because services they need are slated for cuts at the outset, and because a ballooning debt will eventually increase pressure to cut programs people rely on. Spending bills passed by the House in July and September for Fiscal Year 2018 would also continue and worsen years of cuts, totaling more than $8 billion to non-defense programs. This includes slashing or eliminating multiple education programs, apprenticeship and employment services, low-income housing, community development programs, mental health and substance abuse treatment, programs to remove lead and other harmful toxins from homes, and other programs vital to low-income communities. The House spending package fails to renew nearly 140,000 housing vouchers in use this year, including 744 vouchers in Maine, increasing homelessness and housing instability. 

In total, the House spending package cuts critical non-defense programs $5 billion below the already austere sequestration-level spending caps for FY18. 

As the House and Senate have not yet actually agreed upon detailed spending bills for FY18, which began October 1, (this date has now been extended into January 2018) most government programs are operating with funding levels that are flat from 2017. 

While this avoids disastrous cuts to critical low-income programs in the short term, inflation continues to erode them, and it also denies them the additional investments they need to be able to expand to help more people. Before the current stop-gap spending bill expires in December, Congress needs to agree on a bipartisan deal to lift the harmful sequester spending limits on domestic discretionary (annually-appropriated) programs for FY18 and future years that will allow for these necessary investments. As mentioned above, Congressional leadership and President Trump are proposing devastating cuts to human needs programs while also trying to fast-track massive tax cuts for the rich and for corporations. 

Tax cut bills passed by the House and Senate benefit those at the top by, for example, repealing or reducing taxes that only affect taxpayers with the highest incomes. 

Moreover, the Republican tax plan will also slash the corporate tax rate. The bills would not only reduce federal coffers by trillions of dollars over a decade, taking away money that could instead be invested in improving the lives of low- and middle-income Americans, they would starve local and state governments, too, affecting education, public safety, and other services they provide. Taxpayers in the top 1 percent would receive 31 percent of the plan’s net tax cuts in 2018, and 48 percent of the cuts in 2027.

Numerous studies have shown that tax cuts for the wealthy and corporations create few jobs or economic growth, despite the fact that these claims are often used as excuses for such cuts.

President Trump’s decision to end the Deferred Action for Childhood Arrivals (DACA) program threatens to strip from 800,000 young adults – including roughly 40 in Maine – the ability to work legally and, in some states, the ability to drive legally and attend college to better their lives. 

Forcing these individuals, more than 90 percent of whom have jobs, and who are more likely than the general population to start their own businesses,36 to again live in the shadows or be deported will surely not decrease poverty in our nation. 

In fact, a prominent economist has estimated that five years after a repeal of DACA, the nation’s gross domestic product would be $105 billion less than it would be if the program stays in place.37 Additional proposals in Congress that would add work requirements to SNAP or Medicaid would hurt individuals and our nation, not help them. 

Studies have shown that work requirements – including those instituted here in Maine – don’t have a significant effect on work efforts or the well-being of those subjected to them, don’t cut poverty, and in some cases actually increase poverty. 

In October 2014, Maine reinstated statewide time limits for SNAP recipients who weren’t employed at least half-time or in a qualifying work or training program, even if they were searching diligently for a job or working less than 20 hours a week. 

This caused thousands of the state’s poorest residents to lose essential SNAP benefits; participation in SNAP among childless adults subjected to the time limit fell 70-80 percent after the time limit returned. 

At the same time, Maine work rates were nearly the same before and after the time limit. A proposal to add work requirements to MaineCare is also misguided and harmful. More than 30,000 Mainers with low income, and some with chronic conditions, would be subject to a work requirement, premium payments, and asset tests under a proposed waiver. Thousands will likely lose access to affordable health care and have no other means of obtaining it, leaving their medical conditions to worsen and leaving them less able to get and maintain employment. 

This proposal would not only hurt those Mainers directly affected by it, but it would hurt Maine’s economy as well.

Similarly, national proposals to tie work requirements to Medicaid would likely increase the number of uninsured and leave without coverage individuals who can’t work because they are caring for a family member, have a mental health issue, are without access to child care or transportation, or are working but do not have enough hours. Adding work requirements to SNAP nationwide is also misguided, as the vast majority of SNAP recipients are either already working, are looking for work, are unable to work, or are not expected to work (children or the elderly). 

More than 50 percent of households with at least one working-age, non-disabled adult worked while receiving SNAP, with more than 80 percent working in the year prior to or after receiving SNAP. 

In families with children, more than 60 percent of recipients work while receiving SNAP, with almost 90 percent working in the year prior to or after receiving benefits.

The Census Bureau data also shows that in nearly two-thirds of poor families in Maine, at least one person worked at least part time or part of the year. 

In addition to the human toll poverty takes, it is also expensive for our nation. Child poverty alone has been estimated to cost the U.S. economy 3.8 percent of our gross domestic product (GDP), or $672 billion in 2015.  Child poverty results in a less-educated workforce, which reduces productivity and economic output years later, and higher physical and mental health costs. 

Unstable housing among families with children will cost the nation as estimated $111 billion in health and education expenditures over the next ten years.

If our elected leaders really want to boost our economy, and create jobs and a highly-skilled labor force, they would invest in programs that lift millions of children out of poverty, not cut them

Rather than cut, Americans should invest in programs that allow parents to find and keep good paying jobs, like training programs, scheduling and paid leave protections, and child care. And they would require the wealthy and big corporations to pay their fair share, so we can increase these investments. 

We Can – and must – continue to make progress for the millions still struggling. We can – and should – do more to further reduce poverty for the millions of Americans still struggling. 

To achieve this goal, Maine Equal Justice Partners and the Coalition on Human Needs recommend the following actions for Congress and President Trump: 

 Reject cuts to proven anti-poverty programs; instead protect and expand funding for programs including SNAP, Medicaid, housing subsidies and others. 

 Reject tax cuts for the wealthy and corporations that will lead to further cuts in domestic programs. Paying for tax cuts for the rich while cutting programs for the poor, infrastructure investments and public health protections is simply wrong. Corporations and the wealthy need to pay their fair share. 

 Lift sequester caps for domestic discretionary programs to boost investments in education and many other programs. A bipartisan deal, similar to those reached in past years, is needed to lift the austere sequester-level spending caps for FY18 and beyond. 

 Increase federal funding for housing subsidies and child care subsidies. As Congress continues its FY18 appropriations process, it should increase funding to provide millions more low-income Americans in need with access to safe, stable housing and quality, affordable child care. 

 Expand the Earned Income Tax Credit to workers not raising children and expand the Child Tax Credit to families making less than $3,000 a year. A bipartisan group of members of Congress have previously shown support for expanding the EITC, so helping workers without dependent children should be a top priority for Congress. Congress should also act to ensure all low-income children benefit from the CTC. 

 Reject harsh time limits and work requirements for SNAP, Medicaid, and subsidized housing recipients. Congress should end the harsh time limits on SNAP benefits for certain jobless adults willing to work. 

 Congress should once and for all abandon efforts to repeal the Affordable Care Act and instead stabilize the law’s insurance markets. Maine should promptly implement the vote of the people to provide Medicaid to all under 138 percent of the federal poverty level. 

Other states should follow. 

States that haven’t yet expanded health coverage to low-income Americans by drawing down federal Medicaid dollars should do so. Governors of states that have continued to deny health coverage to low-income residents should end this costly failure 9 to take advantage of federal dollars on the table to provide necessary health care to those who can least afford it. 

 Congress should enact the Dream Act, providing legal status and a path to citizenship for the young people brought to this country as children. America is the only home many of them have ever known. They are Americans and should be regarded as such. 

Dreamers deserve freedom to work, learn, and serve in the armed services, where they contribute to economic growth. 

Reducing poverty clearly should be a top priority for our nation. The evidence shows that proven antipoverty programs like SNAP, housing assistance, and low-income tax credits are effective at lifting millions of people out of poverty and building family economic security. As a whole, the U.S. has made progress in reducing poverty and now is not the time to turn back this progress. 
Maine, which has not shared in that progress in recent years, serves as a cautionary tale. Harmful cuts to Maine’s anti-poverty programs have coincided with shameful outcomes related to hunger, health care and child poverty. 

Frankly, the last thing we should be doing as a nation is cutting programs for those who need help the most to give giant tax cuts to those who most certainly do not need it. 

Instead, Congress and the Trump administration must invest more in proven anti-poverty programs to speed up this progress and extend it to more of our neighbors in Maine. 

This report was prepared by Maine Equal Justice Partners and the Coalition on Human

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Thursday, December 21, 2017

Maine is first in nation to expand Medicaid by ballot initiative

Maine Medicaid Expansion: What’s Next (We did it!) 

On Nov. 7, Mainers passed Question 2 with an overwhelming 59% of the vote. Voters sent a clear and strong message: They want more affordable health care, not less. 

More than 70,000 Mainers cannot afford to wait any longer for the health care they need to be and stay well. The magnitude of the victory that we achieved - thanks to years of work by many of you - cannot be over-emphasized in terms of its impact on people’s lives. Thanks to the initiative, more than 70,000 Mainers will gain access to long-overdue, life-saving health insurance coverage.

In fact, the implications for Maine and beyond are significant.

“Voters in Maine approved a measure allowing them to expand Medicaid under the Affordable Care Act (ACA).

It was the first time since the law took effect that the question of expansion had been up to U.S. voters. 

The issue affected many people in Maine, a rural state that has the nation's oldest population and the region's lowest wages.” 

Associated Press ~https://www.apnews.com/cf007502a8dc421990c4d8dfcde19235

PORTLAND, Maine (AP) — Residents in this rural state grappling with a heroin epidemic and an aging population voted Tuesday to deliver a rebuke to Republican Gov. Paul LePage and join 31 other states that have expanded Medicaid under former President Barack Obama’s health care law (The Affordable Care Act ~ ACA).

The referendum represents the first time since the law took effect that the question of expansion had been put in front of U.S. voters.

Some 11 million people in the country have gotten coverage through the expansion of Medicaid, a health insurance program for low income people.


Maine became the 32nd state to expand Medicaid…Voters approved the initiative by a gaping 18-point margin, with support from many conservative, rural areas in the north of the state where expansion will have a significant impact. 

The "Question 2" victory means more than 70,000 Mainers will gain insurance coverage.” 

A clear and resounding message was sent to the Governor by voters. Nevertheless, Gov. LePage issued a statement saying he would not implement expansion if the Legislature didn’t fund it at twice the amount estimated in the bill’s fiscal note from the nonpartisan Office of Program and Fiscal Review ie OPLA. 

Governor LePage's statement caused some to worry about the future of Medicaid expansion here in Maine. 

Maine Equal Justice Partners in Augusta, an independent voice for Medicaid said, "We can assure you. This victory will stand. We will be working together over the coming months to ensure that people get healthcare coverage and the will of Maine voters is upheld. Get the facts on implementation of Medicaid expansion. We would like to answer some of the post-election questions that have come up to help clear up any confusion."

When will newly eligible Mainers get their healthcare coverage? 

The law the voters passed requires the administration to provide health coverage to people within 180 days of the effective date of the law. The administration is therefore required to provide coverage to people who are eligible no later than July 2, 2018. 

Here is the timeline for the implementation

• Nov. 7, 2017 - Ballot measure passed with a strong majority (59% of Maine voters).

• Dec. 4, 2017 – Governor made public proclamation of the election results. • Jan. 3, 2018 - Legislature convenes. Thirty days have passed since the governor’s proclamation and the law becomes effective on this day. 

• Feb. 17, 2018 - While the law is effective on January 3rd, it becomes operative 45 days after the Legislature convenes.

• April 3, 2018 – This is 90 days after the effective date, and DHHS must submit a State Plan Amendment to the federal government by this day.

• July 2, 2018 (state fiscal year ’19) – No later than 180 days after the effective date, people become newly eligible under the law.

Can the governor block this law and prevent people from getting health coverage?

No. The governor cannot veto a ballot initiative. Medicaid expansion is now the law of the land. The Legislature is the only governmental body that can change the law and there is no reason to expect them to repeal it (see Q&A #4). The governor, just like all of us, must follow the law. 

What if the Legislature repeals the new law? 

Even though the Legislature has the authority to repeal or change the law, this is incredibly unlikely. The majority of the Legislature has already passed Medicaid expansion five times. Now, the voters have weighed in and passed it with a strong majority. Legislative champions have already made it clear that this is now the law and the will of the voters will stand. 

What is the actual cost of Medicaid expansion? 

Expanding Medicaid through the ACA is an incredible bargain. Initially, the federal government will pay 93.5% of the cost of coverage for most who would become newly eligible and no less than 90% beginning in state fiscal year 2021. The state’s share is relatively small considering the return on investment of $9 from the federal government for every $1 Maine invests. The official fiscal note from the nonpartisan Legislative Office of Fiscal and Program (OPLA) Review estimated that the state cost of Medicaid expansion once fully implemented at the 90/10 match rate in 2021 will be approximately $55 million a year, bringing in $525 million in federal matching funds. 

The cost of expansion for the first couple years with the enhanced match rate is still to be determined by the Legislature working with OFPR with input from DHHS. 

OFPR has initially estimated that the state’s cost for fiscal years 2018 and 2019 combined would be $45.5 million. This number is too high, however, as it is premised on the assumption that people will gain coverage in January of 2018. The Legislature and OFPR will therefore need to work through the actual cost for this biennium over the coming months. 

Will the Legislature need to cut other programs and services to fund the state’s share for Medicaid expansion? 

No. Medicaid expansion does not involve taking funding from one group to pay for another. It is about taking advantage of an unprecedented, cost effective opportunity available from the federal government to provide health insurance coverage to low income Mainers who can’t access Medicaid now. Providing coverage to more people will help to stabilize our health care system overall. Other states that have expanded their Medicaid programs have not been forced to make cuts to other programs. 

It's wrong for opponents to claim that expansion threatens people on wait lists for home care services. This myth has been debunked throughout the nation. Maine is not facing a budget shortfall, the revenue picture shows an actual surplus, and there are funds available to the legislature to pay for expansion over the next biennium without harming others that need services. 

What if the Legislature does not fund Medicaid expansion during this legislative session? Or what if the Legislature funds it but the Governor vetoes the funding bill? 

Medicaid expansion is the law and people will become eligible for coverage on July 2, 2018 regardless of whether the Legislature has passed a funding mechanism and regardless of whether the governor delays or resists implementation. Once eligible for coverage, people will have legal recourse if they are improperly denied coverage, meaning they will have a legal claim in court. Hopefully, it will not come to that and the Legislature will act swiftly to fund the state’s share and the governor will act swiftly to respect and implement the will of the voters, but regardless, people will become eligible under the law. 

I understand that the federal government must approve Maine’s State Plan Amendment to implement expansion. 

What if the federal government does not cooperate? 

The state administration must submit a State Plan Amendment (SPA) within 90 days of the effective date, according to the new law. The federal government must approve Maine’s State Plan to implement Medicaid expansion, but that should be a routine process that is anticipated by the legislative timeline. 

Usually, this approval takes on average about 82 days. If the federal government delays giving its approval in an obvious effort to thwart implementation, it will be subject to legal challenge. 

How can I get involved to help ensure the law gets implemented and people get coverage as soon as possible? 

The Mainers for Health Care campaign was successful because it was a grassroots, collaborate effort. A Leadership Team of people who would be impacted by the policy were at the heart of the campaign, sharing their stories, recruiting volunteers and knocking on doors. More than 80 state and local organizations endorsed the campaign and helped make it happen. Health care providers, faith leaders, nurses, advocates and concerned citizens joined forces to make this happen for Maine. In that spirit, we will work together to finish the job and get health coverage to people as soon as possible. 

If you would like to join in these efforts and are not already connected to the Mainers for Health Care campaign, please contact Kate Brennan at kbrennan@mejp.org or 1-866-626-7059, ext. 204. 

If you have questions about the policy or the law that we have not answered here, please contact Ann Woloson at awoloson@mejp.org or 1-866-626-7059, ext. 210.

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