Dear Commissioner Mayhew:
My name is Trish, and I introduced myself to you the other day after you testified before the Appropriations and Financial Affairs and Health and Human Services committees.
You were testifying about the administration’s proposed cuts to the MaineCare rolls and reimbursements, and some of your testimony left me confused. Okay, confused and more than a bit worried, which is why I wanted to follow-up with you.
There is a lot to unpack in your testimony, and it’ll probably take at least a couple posts. I’ve spent the last twenty-four hours deciding where to start. I’ll be honest — my first thoughts weren’t so nice.
I thought of comparing our meeting to a scene in the tv sitcom Frasier — the one where home healthcare worker Daphne complains of losing all feeling in her right arm after shaking hands with Frasier’s ex-wife Lilith. Then I thought I’d compare trying to pin you down on an answer to riding on an unsettling merry-go-round with an out-of-tune and skipping calliope.
But you’ve got a lot of power, and my peers don’t. And I’ve got a very public platform to speak from, and my peers don’t.
So I decided the responsible place to start is asking you, begging you, to show mercy. I know you and/or your representatives will be participating in work sessions with legislators, more than a few of whom seemed as worried as I am. It would be such a relief to know you understand the severity of what is being proposed.
Like, the idea of cutting MaineCare eligibility for parents to a 40 percent of poverty threshold or removing 19 and 20 year-olds from the rolls. That’s pretty harsh in a life and death way, especially given our addiction epidemic, which has been particularly hard on our youth. Here in little old Maine, 378 people died of overdoses last year — a sickening number of people succumbing to their sickness.
I just can’t see how someone in charge of healthcare can think cutting access during an epidemic is a good idea, but I guess you do. Please have mercy and rethink that position.
I was disappointed to learn your department did not have any data regarding what happened to recipients with substance use disorders who lost their MaineCare during previous cuts. I guess there’s no way to know if any of them are among the 378. Or are in jail. Or are struggling enough to have lost their children.
I hope not.
I understand the administration’s vision that you articulated, as far as adjusting taxes and cutting government costs to help attract employers to our state. The problem is, even if that kind of strategy were to be viable and that’s a big if, cutting costs in a way that jeopardizes the health of our workforce on the way to that vision is counterproductive.
Again, I’d like to walk you through the hypothetical scenario I tried to raise when we met. A hypothetical young mom has entered treatment and is raising children. She stabilizes enough to land a low-paying part-time job and is developing a work history and the confidence needed to climb further up the ladder.
Her income is below poverty but high enough to lose her MaineCare under this proposal. She relapses and loses significant ground with her responsibilities, maybe even dies. How does that help Maine’s economy grow?
You said I was presuming the mom would relapse. I think you used the word defeatist when a legislative committee member posed a similar line of thought in the hearing. Myself, I thought he was being a realist.
I know my presumption came from what the kids call IRL. In real life. In real life as a person in recovery who has struggled to raise children around the poverty line. In real life as a person who has supported addicts personally and professionally for years. In real life as someone who’s family has been deeply scarred by this epidemic.
My IRL experience knows that losing insurance and getting further behind financially and losing access to treatment — even worrying about losing access to treatment — is enough to bump people off their recovery path, especially early on.
Substance use disorders aren’t the only conditions that require maintenance care to avoid expensive and/or tragic outcomes, either. One committee member used the example of a diabetic for her hypothetical.
Since you offered no clear plan as to how recipients needing maintenance healthcare will be able to access it without Mainecare, I’m not sure why you think I and others are being presumptuous or defeatist with our hypothetical scenarios.
When I asked if you were saying that there was treatment available to anyone in Maine with a substance use disorder regardless of having insurance or the ability to pay, you said that was not what you were saying. You asked me not to put words in your mouth.
I wanted to let you know that with 378 people dying last year and countless others in some stage of active addiction or attempting recovery, there’s a whole bunch of us who would love to hear those words come out of your mouth. We’d be hearing the sound of mercy.
Looking forward to continuing the dialogue and best wishes,