Maine's voters chose Medicaid expansion, but the governor is resisting

Donna Wall cares for her three adult autistic children at her home in Lewiston, Maine. It's a full-time job. Sons Chr...

Posted: Jan 9, 2018 4:21 PM
Updated: Jan 9, 2018 4:21 PM

Donna Wall cares for her three adult autistic children at her home in Lewiston, Maine. It's a full-time job. Sons Christopher and Brandon have frequent outbursts, and the stress of tending to them can be overwhelming.

When her twin sons turned 18 a year and a half ago, Maine's Medicaid program dropped her health insurance. Wall is considered a "childless adult" in Maine and other states that didn't expand Medicaid, and so she isn't eligible for coverage. She can no longer get her antidepressants and anti-anxiety medications. She can't see her psychologist or a doctor to check up on a troubling spot on her eye.

She needs to stay whole, she said, for her kids.

"I'm 60 years old. Things start going wrong when you get older," she said. "I haven't had a Pap smear or breast exam in two years. I'm just worried something will happen to me, because who is going to take care of them? It's a big job. If I put the boys in a home, it would cost the state a lot more to take care of them than it would be to pay my medical."

Even on frigid, wintry nights, Wall delivers newspapers, earning $150 a week when her kids are asleep.

"I try really hard not to fall, but I have had a few accidents. One of them was on black ice last winter," she said.

At least 70,000 low-income Maine residents like Wall should gain Medicaid health insurance because of the ballot measure that passed last fall. Advocates collected signatures to put the question to voters, and, in November, Maine became the first state to get approval to expand Medicaid, passing with 59% approval.

Related: Trump administration eases penalties against negligent nursing homes

But even though voters here in Maine decided to expand Medicaid, the law's fate is unclear. Republican Gov. Paul LePage has said that opening up the program to more poor adults threatens the state's financial stability and that lawmakers shouldn't raise taxes to pay for it.

"You have to pay for the law," LePage said. "It's going to cost money... If they do not fund it, it will not be implemented."

LePage has been in power for seven years, and, because of term limits, is heading into his final year in office. He vetoed five Medicaid expansion bills passed by the Legislature before voters approved it.

Lawmakers must now pay for the new law without raising taxes or dipping into the state's rainy day fund, he said. And he warned that the expansion could threaten services for people with disabilities and the elderly.

"When able-bodied people, who are able and should be working, choose not to work, then I don't think it's society's responsibility to cover their insurance at the expense of our mentally ill, our disabled and our elderly," he said. "We're asking hardworking Maine families to pick up the extra tab for people who should be working, but elect not to be."

Sara Gideon, the speaker of Maine's House of Representatives and a Democrat, said the governor's remarks are not true.

"Let's start with the population of people who will actually be eligible for health insurance now," she said. "We're talking about people, almost 70 percent of whom are people who are actually in the workforce, who are earning a living, but not actually able to afford health care with the low income that they earn."

Gideon said LePage must follow the law. Moreover, she is confident the legislature will find a way to fund the state's share of $54 million and keep its promises to the elderly and disabled.

"It is the law. And we're simply going to make sure that that law is implemented," said Gideon.

For rural hospitals in Maine, the Medicaid expansion can't come fast enough.

"We don't make money. We lost a million and a half dollars the last two years," said Marie Vienneau, CEO of Mayo Regional Hospital in Dover-Foxcroft.

Maine's rural towns and hospitals have been hit hard. Factories have closed and many residents have moved away. As workers lost their jobs, more uninsured patients turned to rural hospitals desperate for medical care but unable to pay. Mayo is facing financial uncertainty, and at least three rural hospitals in Maine have closed in recent years.

Deanna Chevery was laid off after 25 years when the Dexter Shoe Co. factory closed in Dexter, Maine. Now 60 years old and uninsured, she's recovering from an addiction to pain pills prescribed by her doctor for back pain.

She overdosed five times, costing Mayo Regional Hospital more than $200,000 in unreimbursed care. Before Chevery found the charity recovery program at Mayo Regional, she said she was turned away when she sought help because she couldn't pay.

"You can only go so many places. Nobody will take you. They don't care if you're crawling on the ground. I'm just fortunate Dover helps me," said Chevery of Dover-Foxcroft.

But Vienneau said the hospital cannot keep up with Maine's growing opioid epidemic and ever-rising costs without expanded Medicaid.

"You can only go so many years in a row where your business doesn't lose money, before you depreciate to the point that you have to start closing services, decreasing services," said Vienneau. "And then access goes away."

Medicaid advocates, like Maine Equal Justice Partners, are pressuring lawmakers to put the new law into effect quickly. The group has been receiving postcards from around the country congratulating them on becoming the 32nd state to expand Medicaid, and advocates in many other red states that refused to expand Medicaid are eying their own ballot measures, including Nebraska, Utah, Idaho, Florida and Missouri.

Related: 26 year-olds face challenges as they fall off parents' health insurance

Patrick Willard, a senior director at Families USA, a progressive advocacy group based in Washington, D.C., said that after years of Republicans attacking the Affordable Care Act, voters are beginning to shift their views.

"What we have heard is that other states suddenly see an opportunity now to figure out a way that they can get around legislatures that have been holding this up," said Willard.

As state lawmakers in Maine work out the details of the new law, many disagree with LePage about how much it will cost. His administration estimates the price tag will be twice what the Legislature's nonpartisan fiscal office has projected.

If they can't resolve the impasse, LePage said, he will take legal action, if necessary.

"We will go to court, because I know - listen, one thing that I know better than the Legislature is financial responsibility. And I have proven it over the last seven years," said LePage.

Advocates say those who are eligible for Medicaid could enroll as early as this summer. But if there are delays, they too say they will sue.

Just days after our interview, Donna Wall fell during her middle-of-the-night paper route and broke her ankle. She still doesn't have health insurance and is unsure how she will care for her autistic children.

Jason Kane of PBS Newshour contributed to this story. Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

Indiana Coronavirus Cases

Data is updated nightly.

Cases: 735999

Reported Deaths: 13486
CountyCasesDeaths
Marion1007151752
Lake54249977
Allen40946680
St. Joseph36335553
Hamilton35829408
Elkhart28844443
Tippecanoe22475219
Vanderburgh22367397
Porter18946311
Johnson18067381
Hendricks17317315
Clark13036192
Madison12762339
Vigo12501249
LaPorte12086215
Monroe11957172
Delaware10755187
Howard10001218
Kosciusko9466117
Hancock8373142
Bartholomew8098156
Warrick7799155
Floyd7690178
Grant7098174
Wayne7072199
Boone6745101
Morgan6611140
Dubois6166117
Marshall6111112
Cass5876105
Dearborn583178
Henry5785105
Noble565984
Jackson503773
Shelby494396
Lawrence4602120
Gibson437192
Harrison436672
DeKalb430585
Clinton428453
Montgomery425889
Whitley398739
Huntington394480
Steuben391057
Miami383968
Knox372890
Jasper372649
Putnam363760
Wabash355380
Adams342755
Ripley340770
Jefferson331881
White317754
Daviess298399
Wells292081
Decatur285992
Fayette282162
Greene280585
Posey272034
LaGrange268970
Scott267554
Clay261347
Washington242132
Randolph242081
Spencer232931
Jennings230949
Starke219354
Fountain213946
Sullivan212242
Owen203356
Jay197830
Fulton196040
Carroll190420
Orange184754
Perry184637
Rush174025
Vermillion170044
Franklin168535
Tipton163445
Parke146716
Pike135634
Blackford135132
Pulaski117445
Newton108934
Brown102641
Crawford101415
Benton99014
Martin89515
Warren82615
Switzerland7948
Union71410
Ohio57111
Unassigned0417

Ohio Coronavirus Cases

Data is updated nightly.

Cases: 1091623

Reported Deaths: 19528
CountyCasesDeaths
Franklin1268061406
Cuyahoga1132982134
Hamilton804211211
Montgomery518231015
Summit47606955
Lucas42618792
Butler38548585
Stark32661909
Lorain25199486
Warren24390300
Mahoning21795588
Lake20846371
Clermont19880240
Delaware18608133
Licking16488212
Fairfield16327200
Trumbull16196468
Medina15379266
Greene15143244
Clark14096299
Wood13168189
Portage12966206
Allen11740232
Richland11433199
Miami10713220
Wayne8923214
Columbiana8881229
Muskingum8831133
Pickaway8596121
Marion8561136
Tuscarawas8509245
Erie7958155
Hancock6944128
Ashtabula6904172
Ross6876156
Geauga6741148
Scioto6444102
Belmont5978168
Union575448
Lawrence5590102
Jefferson5583151
Huron5462120
Sandusky5380122
Darke5374126
Seneca5311122
Washington5228109
Athens520858
Auglaize494986
Mercer481585
Shelby470293
Knox4513110
Madison439363
Putnam4301101
Ashland426590
Fulton426469
Defiance424697
Crawford3993107
Brown397557
Logan383276
Preble381398
Clinton374163
Ottawa369081
Highland356862
Williams343475
Champaign335358
Guernsey317653
Jackson314152
Perry295950
Morrow287239
Fayette283550
Hardin271964
Henry270366
Coshocton266157
Holmes2625101
Van Wert244263
Adams240053
Pike238634
Gallia236749
Wyandot232155
Hocking216462
Carroll192448
Paulding174340
Meigs145540
Noble134137
Monroe132542
Harrison109637
Morgan108823
Vinton84915
Unassigned02
Fort Wayne
Partly Cloudy
75° wxIcon
Hi: 78° Lo: 54°
Feels Like: 75°
Angola
Partly Cloudy
73° wxIcon
Hi: 77° Lo: 51°
Feels Like: 73°
Huntington
Clear
74° wxIcon
Hi: 75° Lo: 56°
Feels Like: 74°
Decatur
Partly Cloudy
75° wxIcon
Hi: 77° Lo: 55°
Feels Like: 75°
Van Wert
Partly Cloudy
75° wxIcon
Hi: 79° Lo: 53°
Feels Like: 75°
A system will bring spotty showers and thunderstorms to the region Wednesday afternoon.
WFFT Radar
WFFT Temperatures
WFFT National

Community Events