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Megan Michaud is vice president of programs and policy at the Maine Center for Economic Policy.
If the election taught us anything, it’s that the cost of living is way too high. So why are we hearing about cuts that would make health care even more expensive? Because extending tax breaks for the rich comes with a staggering $4 trillion price tag and, to pay for it, Trump advisers and congressional Republicans are reviving old plans to gut Medicaid.
Do Mainers, already struggling to pay premiums and medical bills, want to pay more? We doubt it.
A lifeline for Americans for nearly 60 years, Medicaid is efficient, cost-effective and supported by 71 percent of Americans. Known as MaineCare here, Medicaid provides health care coverage for almost 400,000 Mainers, including older folks, kids and people with disabilities, and it brings in federal money. These proposed cuts would endanger coverage for hundreds of thousands of vulnerable Mainers and cost the state hundreds of millions of dollars.
Thanks to the Affordable Care Act (ACA), which allowed Medicaid to expand to include more people, more than 104,000 Mainers are covered. It’s saved lives, helped fight the opioid crisis and detected cancer early. Maine pays only 10 percent of these costs and the federal government picks up the rest. For every $1 Maine spends on expansion, we get nearly $10 back in federal funds. Repealing this federal support would cost Maine $177 million in 2025.
Another bad idea on the table: A Republican plan to slash general federal support for Medicaid, cutting Maine’s funding by a staggering $800 million annually. That’s pulling the rug out from under older Mainers in nursing homes and kids needing routine checkups. Thousands could lose coverage.
Remember the disaster of welfare block grants in the ‘90s? States got “flexibility,” but families got crumbs. Under Gov. Paul LePage, Maine hoarded millions in unused TANF funds while families went without help. Now, some want to do the same with Medicaid. Block grants cap funding regardless of need. Got a pandemic or economic downturn? Tough luck. Inflation eating into your budget? Too bad.
Another rotten idea: per-person spending caps. Sure, states get more money if enrollment rises, but the cap doesn’t adjust for real-life costs. Health care prices rise faster than inflation, and older Mainers often need pricier care. Maine trying to cover rising nursing home wages, which are badly needed to safely staff facilities, or tackle new health crises while stuck under a rigid cap is like trying to fix a leaky roof with duct tape.
Republicans in Congress also have proposed “work requirements” — the bureaucratic hoops that sound like tough love but achieve nothing. Most Medicaid recipients are already working or are unable to due to age, disability or caregiving. For the small number who aren’t, barriers like health issues or lack of transportation make it nearly impossible. Work requirements just bury people in paperwork and many end up losing coverage — even when they’re already working.
Maybe the worst idea? Medicaid lifetime coverage limits. Imagine hitting your “health care limit” after a cancer diagnosis or a major accident. It’s like the bad old days before the Affordable Care Act, when one car accident or chronic illness could bankrupt you. For the 63,000 people with disabilities and 65,000 older people enrolled in MaineCare, this isn’t just unfair — it’s inhumane.
Medicaid isn’t just a program — it’s a decades-old promise. A promise that kids get checkups, older people can get full-time care and families don’t have to choose between rent and medical bills. Sure, slashing Medicaid might trim federal spending, but the costs just get dumped on states like Maine and our people, already stretched to make ends meet. It’s not just a bad deal — it’s like trading a life preserver for a cinder block.
The message to lawmakers should be clear: Don’t just reject these harmful ideas — bury them. Protect Medicaid, protect Maine and don’t mess with what works. Our health and future depend on it.