Revision: In the post below, I incorrectly analyze a proposal by the LePage administration and DHHS Commissioner Mary Mayhew included in the most recent budget. I based my analysis on the idea that working parents earning 140 percent of poverty would lose their Mainecare. I run a hypothetical case involving a single mom of two who is accessing methadone treatment for an addiction she developed while in the care of a trusted, state-licensed medical professional.
I ran estimates of her monthly costs, including paying for her own methadone treatment, and clearly show that her costs exceed her income.
My bad. It turns out my hypothetical mom has already been kicked off Mainecare with a current threshold of 100 percent of poverty. It turns out what Mayhew and LePage are proposing is kicking people at 40 percent of poverty off Mainecare.
In case you don’t think you just read right — LePage and Mayhew are expecting working parents living BELOW the poverty line to cover their own healthcare costs.
I sat down to re-run my budget numbers because a couple things would change — like my hypothetical mom would receive a bigger childcare subsidy at 40 percent of poverty and more SNAP assistance — but neither increase would cover their total costs. Further, there are no car payment/insurance subsidies or subsidies for many of the other costs I lay out.
Trying to run those numbers made me cry. No exaggeration. It triggered all the resentments I harbor about how difficult it was to try to make it as a single mom over the last 15 years. Let me tell you, it’s almost impossible to raise children on your own, to foster their well-being and foster a career or other vocational means to support them while dealing with the nitty-gritty of poverty. I could never (and still haven’t) escape the feeling of failing.
And I wasn’t trying to do it at 40 percent of poverty.
In the post below I also write about the inconsistency of funding treatment for uninsured people with substance abuse disorders right before creating a bunch more uninsured people through the proposal at hand. Not only will kicking more people off Mainecare weaken the treatment component of our fight against our addiction epidemic, as far as I can tell, LePage’s budget doesn’t include anything specific to addressing the epidemic, either.
In case Mayhew and LePage are unaware, addiction is a deadly disease. Deadly diseases quickly spread into public health crisis when unaddressed, as is exhibited by overdose deaths that escalated to one a day Maine at the end of last year. Removing access to healthcare during a public health crisis isn’t sound policy — it isn’t humane policy. It’s essentially a death panel where monetary value is the primary delineation as to who gets to live and who doesn’t.
So here’s my revision: For shame, Governor Paul LePage! For shame DHHS Commissioner Mary Mayhew! For shame, any legislator who has enabled this administration’s lowering of the Mainecare threshold and who is considering allowing them to lower it more during a public health epidemic. I am sorry I incorrectly interpreted the LePage administration proposal, but it’s hard to fathom what they are really proposing, even as I stand corrected.
If anyone happens to have a spare moral compass for that team, please do send it their way.
A few weeks ago I was celebrating the news that Maine Department of Health and Human Services was freeing up funds to help the uninsured access treatment for addiciton. The department had enough money to target 359 of the estimated 450 uninsured on waiting lists.
As much as I tried to be upbeat about it, the realist in me was thinking, wait for it …
After too many years with a basketball in my hands, the announcement sounded like a bureaucratic head fake, and the real move was yet to come. The idea of making significant progress with the addiction epidemic seemed uncharacteristically compassionate for department commissioner Mary Mayhew and the LePage administration — and uncharacteristically logical.
Sure enough, the illogical thinking returned quickly in the form of a proposal to kick working parents earning 140 percent of poverty off Mainecare. It’s one of the highlights in Governor LePage’s budget currently being reviewed by lawmakers.
Maybe in Mayhew’s head it makes sense to increase the number of uninsured poor so soon after working on those waiting lists of uninsured poor, but I’m not sure how. I’m assuming some of the recipients who may be removed from the Mainecare rolls under this proposal are people in need of treatment or are people currently accessing treatment for addiction.
I’m also assuming that addressing the addiction epidemic is so important to our lawmakers that they will ask DHHS officials exactly how many recipients with substance abuse and/or other mental health disorders would be affected by the proposed cut. The state is already failing too many of those folks.
The proposed Mainecare cut is not only illogical, it’s math is fundamentally flawed.
Let’s imagine a hypothetical single mom with two kids. One’s a toddler; one’s in elementary school.
Let’s say this mom developed an addiction while receiving care from a trusted medical professional and has since begun methadone treatment as part of her recovery. It’s a fairly common storyline here in Maine.
Because of her treatment, our mom’s been able to get off TANF by finding a job that, miraculously, allows her to work during the day M-F, and, equally as miraculously, pays $544 a week — one dollar per week over 140 percent of poverty.
And just enough to lose her Mainecare if Mayhew has her way.
It’s not clear whether the poverty figures being used by the LePage administration are before or after payroll deductions. Given the miserly nature of past welfare reform proposals, I’m going to guess that the figure is before Social Security and unemployment payroll deductions, but it doesn’t matter. Whether before or after deductions, 140 percent of poverty does not cover basic costs for our hypothetical mom.
What are her monthly costs?
$600-$650. Unless she’s accessing subsidized housing, that’s about the least our hypothetical mom could spend for an apartment here in Augusta. Safe, tolerable subsidized housing is hard to come by and usually involves waiting lists. Our hypothetical mom probably could spend a little less for a tinier one-bedroom, or she could get into a less desirable subsidized housing complex, but chances are either of those choices means raising your children amidst active addiction, drug-dealing, and prostitution.
Been there, done that, and it makes for some colorful family conversations, let me tell you.
$300. Unless she’s living in-town Bangor or Portland, chances are this mom needs a car to get the kids to and from daycare and school and to get to work. I base this number on the car payment/full insurance costs of a young single mom that I helped a couple years ago.
Personally, I think she could have done a little better on the car payment side, but the folks selling cars to inexperienced first-time buyers with checkered pasts aren’t always concerned with making the bottom line work well for that rookie buyer.
And those rookie buyers aren’t always willing to listen to the advice of their wise, old aunties …
$244-500. Summer-care and after-care for elementary school-age children is expensive. In Augusta, it runs $61 per child per week during the school year and $125 in the summers.
$550-800. Full-time childcare for a baby or toddler costs enough to make parents grateful when the kids hit school, which is sad. Parents should be treasuring the years with little ones, not wishing them away. Our hypothetical mom might receive some subsidized help with this cost, but in my experience talking to single moms, it isn’t significant, especially at that income level.
$350-400. Groceries, diapers, personal care and cleaning products are the expenses that grind a parent down psychologically as the checkbook depletes before the next direct deposit arrives. If someone can feed two kids while working full-time and raising them on your own for less than the amount I suggest, I bow to you. I never came close to keeping it that low when I was working and both my boys were minors living at home.
Near as I can tell, doing so would take considerable time gardening (if gardening space is available) along with canning/freezing and lots of cooking from scratch using very basic ingredients. Theoretically possible, yes, but not realistically possible for most working moms, and I say that as a mom who loves to cook and bake from scratch.
$380. Methadone treatment for the uninsured doesn’t come cheap, and it’s pay as you go or they decrease your dosage quickly and show you the door. I base this figure on what an uninsured person I know is actually paying monthly in cash.
$100. If the mom is incredibly frugal she could possibly get her electric, landline, and internet costs down to that figure. Spare me the internet-is-a-luxury crap. Internet is now a requirement if children want to keep up with school work and if parents want to be upwardly mobile in the workforce.
$60. Gas for getting to work and daycare and the clinic and the laundromat isn’t cheap, but again, with frugality our mom might be able to get by on this much depending on the distance to her work.
$50. Laundry sucks. In the three apartments I’ve lived in in the last 15 or so years, not one had laundry. I usually do mine at my mom’s house, but I was appalled by the cost of the laundromat last time I went when her washing machine was down.
Readers don’t have to be math whizzes to see I already exceeded our single mom’s income with only a portion of my unfinished list. I haven’t allowed for car maintenance/repair/registration/inspection. I didn’t include birthdays, seasonal holidays, school pictures, field trip costs or activity fees. I didn’t even bother with the cost of clothes, shoes and boots.
I didn’t add a cell phone to help our hypothetical mom keep track of her chaotic life or the premium for a healthcare plan for her.
Aside from questioning Mayhew’s critical thinking, math, and reading/research skills, I have to wonder if Mayhew has any understanding of the lives of recipients of her department’s services. Or the obstacles recipients face as they try to rise up out of poverty.
If Mayhew thinks 140 percent of poverty is enough for a parent to cover basic family expenses as well as his or her own healthcare costs, I’m guessing she doesn’t.