“If we are to bring our welfare system to a manageable level that Maine can afford,” LePage insists, “we must make the necessary structural changes. … The state can no longer use gimmicks to fill the hole.”
The size of Maine’s Medicaid shortfall is substantial, but it pales in comparison to gaps in many other states. In fact, health experts in Maine say the program has survived far bigger shortfalls in recent years without cutting the rolls. Still, LePage argues that the program can no longer provide a “free lunch” to poor 19- and 20-year olds, or to healthy adults responsible for the care of others.
Some of LePage’s proposed Medicaid cuts, such as eliminating dental care, physical therapy and chiropractic services, are not too different from ones that governors in both parties are recommending in states across the country. Neither are his proposed reductions in payments to hospitals and doctors or limits on prescription drug coverage.
But LePage also wants to get at enrollment, and this is what makes him, at the moment, the most draconian of the governors when it comes to health policy. In his January 24 state of the state speech, LePage argued that “we have encouraged people to rely on the taxpayers, rather than rely on themselves.” The cuts to enrollment, he argues, are necessary to shore up the state’s safety net so it can continue to care for its most vulnerable residents – children, elders and the disabled.
But for many of Maine’s citizens, the enrollment cuts would be life-changing.