Republican Sen. Tom Saviello on why he keeps trying to expand Medicaid

Senator Tom Saviello (Photo provided by Sen. Saviello)

Sen. Tom Saviello, R-Wilton. (Photo provided by Saviello)

Back in December I had the good fortune to interview Rep. Drew Gattine, a Democrat from Westbrook. He co-chairs the legislature’s health and human services committee, and I wanted to offer readers a deeper look at the challenges facing the committee this session. The conversation was enlightening, and one of the things we talked about was the contentious issue of MaineCare expansion, possible under the Affordable Care Act.

Gattine said the legislature would be considering a bill sponsored by Sen. Tom Saviello, R-Wilton, that had been carried over from the first part of the 127th session. The last two legislatures have passed MaineCare expansion bills five times, and Gov. Paul LePage has vetoed each one. Saviello is a Republican supporting the issue largely driven by Democrats.

The hardest part about interviewing Saviello was trying not to laugh too hard as we swapped stories about the wonderful people from his district, which covers all of Franklin County and Belgrade, Fayette, Mt. Vernon and Vienna in Kennebec County. Over the years I’ve had close personal ties throughout his district and have developed a fondness for the communities of that region.

Sen. Saviello rocking a moose antler hat and a must-have jelly jar wine goblet. (Photo provided by Sen. Saviello)

Saviello models a moose antler hat and a must-have jelly jar wine goblet. (Photo provided by Saviello)

Saviello talked about participating in Weed Whacker Tosses and games of horse shoe using toilet seats at an Avon community event. I brought up the guys in Mt. Vernon who used to attend community events on the mobile picnic table — a picnic table and cooler affixed to a four wheeler. I’m sure there was at least some duct tape involved, and seeing something like that at a Memorial Day parade is all you need to see to know why you live in Maine.

Mutual love of that chunk of rural Maine aside, Saviello is serious about his responsibilities to his constituents and to his colleagues in the legislature. He loves his constituents — so much so that he lists his relationship status on Facebook as “complicated.” Saviello invests considerable time in this “love affair” with his constituency, from letters to anyone who gets a picture in one of the four local papers, which he reads daily, to participating in local celebrations, to moderating town meetings.

Senator Saviello speaking at the MT Blue JMG ceremony. (Photo provided by Sen. Saviello)

Saviello speaking at the Mt. Blue Jobs for Maine’s Graduates ceremony. (Photo provided by Saviello)

And his constituents love him back. Saviello is serving his third term and is proud to have received more votes than any other sitting senator. He hopes to have the honor of serving his district one more time before retiring to his family, his community of Wilton and his business.

Saviello compared serving in the legislature to being in high school, with his third term being the equivalent of his junior year. He’s over the freshman jitters, and he became more acclimated during his sophomore session. Now as a junior, Saviello likes knowing enough about “how the system works to be able to make a difference.”

Good relationships with his colleagues are a critical part of his work. He is chairman of the environment and natural resources committee, and is proud of its members’ bipartisanship. The committee has handled 60 bills this session, and only three or four came out as divided reports; the rest were either approved or killed mostly unanimously.

Saviello explains that there are indeed differences between the views of committee members, but as chairman he wants “to ensure that everybody’s side is heard about a bill from the public to the various committee members.” He tries to foster a healthy debate, so committee members can reach an informed consensus in most cases, which results in less time wasted for fellow legislators when bills come out of his committee.

It’s not always a perfect process, though, and Saviello referred to a mining bill, LD 750, that was voted down in the House during the first part of the session. The bill was intended to make modifications to a 2012 bill, and Saviello and Rep. Robert Duchesne, D-Hudson, spent considerable time drafting changes. While Saviello was proud of the work he and Duchesne and other committee members did, he learned a valuable lesson about the role “marketing” can play in a bill’s success or lack thereof.

Saviello regrets not focusing more attention on informing and explaining, and on framing discussion around the proposed changes better — lessons that will apply to his attempt to help the legislature reach some kind of consensus regarding MaineCare expansion.

When I asked why he supports an expansion, Saviello replied quite simply, “Because my community needs it.” He talked about representing many constituents who “fall below or just above the poverty line” and about his local hospital being financially burdened by charity care costs. Charity care is free medical care provided by hospitals to patients who do not have insurance and whose incomes fall below levels necessary for hospitals to bill them for care, which leads to increased costs for everyone — from the hospitals themselves to people paying for private insurance.

Medical insurance enables people to access preventive care, something Saviello came to appreciate when he faced a health crisis of his own years ago. He hadn’t been feeling well, and when a colonoscopy showed a small amount of cancer, he was able to have it removed immediately with only routine check-ups as a follow-up plan — “a $1,500 fix.”

Saviello worries that constituents without insurance wait to receive care because they cannot afford regular doctor visits. Were someone in his situation to wait, a problem that was a “$1,500 fix could quickly become a problem that costs $50,000 to $100,000” and possibly a life if the person didn’t survive. His own health crisis made him realize how lucky he was to be insured. He referred to Maslow’s Hierarchy of Needs, which establishes physiological needs as the most basic need for human survival.

Saviello firmly believes that access to health care is a fundamental basic need necessary to help people become as productive as they can possibly be.

The addiction epidemic has added a sense of urgency for Saviello, though, that goes beyond his initial support for an expansion. On a personal level, someone who grew up with his kids recently died of an overdose, and his heart is broken for that family. On a legislative level, he is hearing from everyone — law enforcement, health care professionals, citizens — that a lack of insurance is a big problem for people with substance use disorders seeking treatment.

He sees a role for expanded MaineCare as a critical tool in addressing the addiction epidemic. It’s a tool that can be used for people in the community seeking treatment and for people whose addictions may have contributed to criminal convictions that result in incarceration. Saviello foresees being able to offer folks leaving jail and prison the support they need as they transition back to the community, hopefully accessing treatment and other services necessary to recover from addiction.

A recent report he read indicated that three states that expanded Medicaid (MaineCare) access are seeing lower recidivism rates in the wake of expansion. Saviello hopes that his fellow legislators unanimous desire to address addiction in our state will tip the scale in favor of expansion.

The proposed expansion would be different than some might think. It is modeled after programs in a few other states, like Arkansas, Indiana and Kentucky, that received waivers from the federal government enabling these states to expand using private insurers. Saviello has been in contact with officials from these states to learn about their systems and how they are working. He admitted he’d heard that Arkansas is having problems but was confident that such potential problems could be addressed while creating a model for Maine.

No one knows more than Saviello that any proposed expansion of MaineCare faces a steep uphill climb after five vetoes that were not overridden by legislators, but he remains optimistic. He plans to be thorough in his research and proposal, as well as in the packet of information he plans to give to every legislator. Beyond that, he doesn’t plan to do much in terms of lobbying or pressuring; he hopes his colleagues will duly consider the proposal and vote their conscience, even if it may not be along party lines.

Saviello uses this approach to every vote he personally casts regardless of the issue. He said, “If something goes to the floor and there’s a debate on it, whether I vote for or against, if you ask my why, I will have a reason.” Calling it “trying to be a statesman,” Saviello plans to appeal to this same sensibility in his colleagues as he asks for their support.

He said 58 percent of his constituents support an expansion (30 percent are against, and the remainder are undecided). Saviello is collaborating with law enforcement, emergency room doctors and prosecutors to build a broader coalition around the idea of expansion. He openly acknowledges that he may not succeed, but he asserts that he is going to give it his all and “has more wrapped into that [MaineCare expansion] than any other bill.”

“It’s about my love for the people,” Saviello said, “It’s the right thing to do.”

Patricia Callahan

About Patricia Callahan

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