Thursday, June 13, 2013

Medicaid Expansion to “Provide for the General Welfare.”

In The Star Herald, June 5, Representative Alexander Willette uses welfare pejoratively 6 times.  He calls it “irresponsible” and the cause of “hospital debt.”
But the United States Constitution has a very different view of welfare.  In the preamble, “promote the general welfare,” is used as one of 6 reasons for establishing the Constitution.  In Article 1, Section 8, “provide for . . . the general welfare” is listed as one use for Congress’s  “Power To lay and collect Taxes.”  Medicaid expansion is a good way to “promote and provide for the general welfare” for tens of thousands of working poor in Maine who won’t be able to pay their hospital bills without it.
It benefits hospitals, taxpayers, and job seekers as well.
Willette accuses Representative Robert Saucier and his Democratic friends of reneging on their promise to pay the debt and of playing party politics because they attached Medicaid expansion to the bill to pay the hospitals.  But there was a good reason to combine the two issues.  According to Matthew Stone in the Bangor Daily News April 2, 2013, a Kaiser Family Foundation analysis “projects Maine’s hospitals would see $348 million more in payments from Medicaid over the next decade if the state expanded the program. Hospitals also would have to provide less care for which they aren’t paid.”  Both the Maine Hospital Association and the Maine Medical Association support Medicaid expansion. 
I can’t agree with Willette’s assertion that past welfare expansions “caused the hospital debt.”  Providing health care to those who can’t afford it may have contributed to unpaid  hospital bills, but it was the Maine state government’s inability or refusal to pay that caused the debt.   
Willette’s accusation that Saucier, in supporting Medicaid expansion, broke his promise to bring jobs to Aroostook County is contradicted by a statement of Gordon Smith from the Maine Medical Association:  “A Medicaid expansion could support the creation of about 2,000 health care jobs” (Matthew Stone. BDN.  March 5, 2013).  To create the most jobs, Maine needs to pay the hospital debt and expand Medicaid. 
Willette’s attack on Saucier is unreasonable and unjust. 
Shorter version published  June 10,   Bangor Daily News.