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October 2, 2017

Maine Hospital Association supports Medicaid expansion

The Maine Hospital Association, which represents all of Maine's 36 community hospitals, has come out in support of Question 2, the Medicaid expansion referendum question that will be on the Nov. 7 ballot.

In a statement explaining its position, the association said it continues to support Medicaid expansion as the best means to provide access to health insurance coverage for Maine's neediest individuals.

Here are the reasons outlined in MHA's news release about its Question 2 endorsement:

  • "There is no other viable option for health insurance coverage for many of the individuals who will benefit from expansion. For many, it is Medicaid or nothing.
  • "The pool of federal funding that is available to Maine to cover the vast majority of the costs of expansion resulted, in part, from Medicare cuts imposed on hospitals in the ACA. Without expansion, hospitals in Maine continue to suffer the pain of those cuts without the corresponding gain from expansion.
  • "The [LePage] administration and Legislature in Maine have taken actions over the past four years that have contributed to reduced reimbursement to hospitals in the Medicaid program. Those cuts have resulted in hospitals receiving $60 million per year less than they did just four years ago. That is in nominal dollars; if adjusted for inflation, the loss would be even higher.
  • "Maine hospitals had an aggregate operating margin of 0.3% in calendar year 2016. Approximately 19 hospitals are in the red and many are being forced to make drastic cuts to programs their communities rely upon. Charity care costs for uninsured poor Mainers costs hospitals over $100 million per year.
  • "Hospitals are sensitive to the challenges of balancing a state budget. Expansion does include a real cost to the state. This year, the state increased school funding by over $100 million, added money to its rainy day fund and still has a budget surplus at the outset of state fiscal year 2018. Accordingly, we believe there are opportunities to responsibly finance the state's share of expansion costs."

Misgivings about citizen referendum process

MHA's board, however, reiterated its previous misgivings about "using the citizen initiative process to achieve policy goals. Ultimately, there is no way to responsibly or fairly implement policy changes without going through the Legislature itself."

The board pointed out that on the day it met to discuss Question 2, the Legislature was holding a public hearing on its significant re-write of the marijuana legalization referendum passed by the voters last November.

"The issue of Medicaid expansion, if passed by the voters, will come before the Legislature next year and our members are ready to work with the Legislature to ensure that it is implemented in a manner that is best for Maine," the board stated.

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