AUGUSTA, Maine (AP) — Many states are gearing up to enroll more residents into Medicaid coverage starting in January.
Meanwhile, in Maine, thousands of people are preparing to lose their Medicaid coverage because of changes to the state’s program and officials’ decision not to expand coverage using new funding provided by the Patient Protection and Affordable Care Act (PPACA).
Today, about 361,000 of Maine’s 1.3 million residents now get their health coverage from Medicaid, according to state figures.
More than 15,000 low-income parents could lose Medicaid coverage in January when changes to the state’s Medicaid program are set to kick in. An additional 10,500 adults with no dependent children and incomes less than $11,500 are facing the end of their coverage this winter even though they would have kept their coverage if the state had agreed to expand Medicaid.
Portland resident and U.S. Navy veteran Tom Ptacek is one of them.
Ptacek, 46, struggled to find work after serving in the Navy as a psychiatric technician. He worked the overnight shift at a gas station convenience store before leaving with the intention of finding a better job. But instead, he stumbled through rejection after rejection and eventually lost his home.
“What I didn’t realize was that I had gotten to a place emotionally where my tank was empty,” he said. “I just didn’t have anything left and … it took a couple weeks for me to build up the confidence to get out there and put applications in.”
After a year in a homeless shelter, Ptacek received housing through a grant from the Department of Veterans Affairs. He now makes $40 a week working as an advocate for the homeless.
The cuts to Medicaid, administered as MaineCare in the state, were meant to address several financial challenges facing the program when Republican Gov. Paul LePage took office, said Mary Mayhew, Commissioner of Maine’s Department of Health and Human Services. Several million dollars the state had been receiving from the federal government to support the program during the economic recovery dried up, she said.
“So we had to come in with a budget that looked across the board at eligibility, benefits and rates of reimbursement,” Mayhew said.
PPACA lets states expand Medicaid to adults making up to 133 percent of the poverty level, or about $15,500 for an individual. The federal government offered to pay 100 percent of the costs for the expansion until 2016 when a portion of the costs would be shifted onto the state.
LePage vetoed the plan, calling it “welfare expansion” and saying the long-term costs of the program were unsustainable. Democrats have a majority in the Legislature, but they failed to get the two-thirds majority needed to override his veto.
The governor insisted that Maine shouldn’t expand coverage to more people because the state’s current system isn’t working properly. LePage and legislative Republicans point to 3,100 disabled Mainers who need home- and community-based service but can’t get funding for them under the current program.