In welfare reform debate, don’t forget companies with employees on Medicaid

A long time ago I asked a mentor of mine how certain “powers that be” were getting away with some pretty questionable activities at the juncture of public and private funds. He told me it was all about what part of the story gets told, what numbers get presented. It’s all about picking what gets attention.

Our current political leadership’s idea of what constitutes welfare reform is a good example of such selective perception. And I hold both parties accountable in this regard. It is so much easier to whip people into a frenzy over “Red Bull” purchases than to undo the underpinnings of these programs and critically analyze their efficacy and their interaction with our larger economy.

Rep. Jeff McCabe, D-Skowhegan, introduced a bill that sought to do just that with the MaineCare program. LD 1324 was designed to require quarterly reports from employers with more than 50 employees regarding the number of employees and/or their family members receiving MaineCare. The report was to include data regarding levels of employment and availability of health care coverage.

Doctors help an accident victim in a shock room at Ben Taub General Hospital on Monday June 11, 2012 in Houston, Texas. (Aaron M. Sprecher/Kaiser Family Foundation/MCT)

Doctors help an accident victim in a shock room at Ben Taub General Hospital on Monday June 11, 2012 in Houston, Texas. (Aaron M. Sprecher/Kaiser Family Foundation/MCT)

This bill was presented to the Labor Committee and was killed in the Senate on June 9. It received very little press coverage and was not deemed as welfare reform, but it most certainly was the most intriguing potential piece of welfare reform legislation I heard about this session. The issue of welfare programs as employment costs subsidies for large, public for-profit corporations is a big pet peeve of mine.

The Legislature needs to get a handle on how many large companies are manipulating the system this way. If employees’ wages and hourly work limitations (i.e., employers limiting hours employees can work to deem them part time) appear designed to minimize employers’ health coverage costs, the Legislature could take action on real reform.

Programs like MaineCare, which is Maine’s Medicaid program, could decrease the number of recipients who should be able to access health care through their employers, creating openings for people who are really unable to access insurance from their employers and people who are unemployed, underemployed or unable to work for various reasons.

Whether people like it or not, MaineCare is an essential component of our health care infrastructure and an essential part of Maine’s larger economy. Firming up its efficacy and maximizing the direct and indirect federal funds garnered through the program should be one of the top priorities in the second session of the 127th Legislature.

Expanding MaineCare should be high on that list, too, because Maine is missing out. A recent report released by the Obama administration projects what would have been gained by having the expansion in place for 2016:

  • an estimated 40,000 people gaining access to health care coverage
  • an estimated 5,700 fewer people experiencing financial insecurity because of medical costs
  • an estimated $430 million in federal funds
  • an estimated $40-million reduction in uncompensated care costs

The report is more comprehensive, but that last bullet is another example of the selective perception of our political leadership. LePage touts his efforts to repay hospital debt in his first term as one of his great accomplishments. Yet he ignores the Maine Hospital Association’s support of the MaineCare expansion. He ignores their bottom line reality of having to eat uncompensated costs that could be covered, at least in part, by the federal government.

It’s all about picking and choosing.

Endnote to anyone who may perceive my endorsement of expanding MaineCare as a blanket endorsement of Obamacare: Unequivocally, I do not agree with every facet of Obamacare, but that is an entirely separate blog post.

Patricia Callahan

About Patricia Callahan

Trish is a writer who lives in Augusta. She has worked professionally in education and social services.