Maine health care advocates say the Senate health care bill released Thursday would be disastrous for Maine. They say it would limit access, increase costs and make deep cuts to Medicaid — a program that, among other things, pays the bulk of Maine’s nursing home resident’s bills.
It’s called the Better Care Reconciliation Act, but Steve Butterfield of Consumers for Affordable Health Care says he can’t figure out who gets better care under this proposal.
“Pick a piece of this and I’ll tell you how terrible this is going to be for Maine,” he says.
One thing that stands out to Butterfield is that the bill allows insurance companies to charge older consumers up to five times more than younger ones. The current cap is three times more.
“That’s terrible, you know, for the oldest state in the country,” he says.
The proposal also ends the federal government’s guarantee to match state Medicaid spending no matter how it fluctuates. Instead, federal Medicaid dollars would be capped on a per-person basis. The capped amount would grow by a set rate over time every year but, Butterfield says, not enough to keep pace with health care costs.
“The long and short of it is, the way that this program radically and permanently restructures the way Medicaid is financed is going to hammer an older, sicker, rural state like Maine,” he says.
That’s because Medicaid pays the bills for 65 percent of Maine’s nursing home residents. It also pays for half of the births in the state, and provides care for people with disabilities.
Though the program reaches far, its pockets are not deep. Ann Woloson of Maine Equal Justice Partners says reimbursement rates are already too low in Maine.
“Under this per capita cap proposal, Maine would be less likely to address workforce issues that are significant and seen as necessary in order to meet current needs, let alone needs of the future,” she says.
Woloson says when the Senate inherited the House version of the bill passed by Republicans back in May, members pledged to start from scratch. Instead, she says, this proposal largely mirrors the House bill and makes some things even worse.
“This is not what people were looking for when they were looking for change. They were looking for increased access and affordability, and this bill does just the opposite,” she says.
“We’re very worried about the impact on patients,” says Andrew MacLean, spokesman for the Maine Medical Association.
MacLean says the Senate proposal, which eliminates subsidies and changes tax credits, would result in consumers paying more for health plans that offer less.
“It’s going to be poorer coverage and we’re concerned about that resulting in poorer care for patients,” he says. “Delayed care, and likely poorer outcomes.”
The bill would allow states to forego the 10 essential health benefits that are required to be covered under the Affordable Care Act — things like prescriptions, emergency and maternity care, and mental health and substance use treatment. It also would defund Planned Parenthood for one year.
In a video statement posted on Facebook, independent U.S. Sen. Angus King of Maine called the bill cruel because it will take away health care for so many.
“And all of this in the name of a huge tax cut for the wealthiest Americans. The top 2 percent are the ones who get the benefit,” he says.
Republican U.S. Sen. Susan Collins of Maine was more cautious in her reaction. A spokeswoman issued a written statement that Collins has a number of concerns, but will carefully review the bill and the CBO analysis that’s expected next week.