Latest news with #MaineCare
Yahoo
4 days ago
- Health
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Maine lawmakers give preliminary approval for student mental health funding
One in six Maine children have been diagnosed with anxiety, and 7% are struggling with depression, according to data from the John T. Gorman Foundation.(Photo by Getty Images) As the state continues to grapple with its record of not providing adequate behavioral health support for young people, a proposal to make funds available for schools to hire licensed behavioral and mental health experts has received initial backing from the Maine Legislature. The Maine House of Representatives passed LD 858 on Wednesday with 79 members voting in favor and 68 opposed. The Senate passed it without a roll call vote. The bill, sponsored by Rep. Lori Gramlich (D-Old Orchard Beach), will go back to both chambers for final enactment votes. The bill establishes a program within the Maine Department of Education to provide grants to districts that contract licensed professionals for behavioral and mental health services. The funds can only be used to cover those not otherwise covered or reimbursable through MaineCare, the state's Medicaid program. Proponents of the bill — including educators, administrators and medical professionals — say the grant program is much needed as Maine educators are not adequately trained to manage worsening student behavior issues, according to a 2025 Maine Education Policy Research Institute report. Critics of the proposal said it infringes on a parent's rights when their child seeks counseling at school, and raised concern about the limited information about what kind of services would be covered under the grants. Gramlich said one in six Maine children have been diagnosed with anxiety, and 7% are struggling with depression. Further, 20% of Maine children have experienced two or more Adverse Childhood Experiences — higher than the national average of 17%. ACEs include experiences like violence or abuse, and the stress and trauma that accompanies them can have a lasting negative impact on a child's wellbeing, according to data from the John T. Gorman Foundation that she cited during the floor discussion Wednesday. 'Some school districts do offer these types of services in a school-based setting, but the current availability of school-based services is nowhere near adequate. Even when these school-based services are currently available, the funding of these services is so lean and precarious that the future of these programs is constantly in question,' she said, of the proposal that will cost $1.3 million in state funding. 'These kids need help now. LD 858 would be an important step toward ensuring Maine students have the mental and behavioral health services they need,' she said. Rep. Sheila Lyman (R-Livermore Falls) raised concern about what she said was a lack of clarity around the scope of services provided. 'What specific behavioral and mental health interventions are we funding? Who decides what is appropriate for each child, and how will parents be informed or asked for consent?' she asked. 'This bill does not sufficiently protect a parent's right to know and direct the mental and behavioral care their child receives in a school setting,' Lyman said. The Legislature passed a similar bill last year that died on the special appropriations table, where bills that pass but aren't otherwise provided for in the state budget compete for remaining funds. Those that are not explicitly funded by the budget committee ultimately die. Maine has a record of not providing adequate youth mental health support. Last year, the U.S. Department of Justice filed a lawsuit against the state under the Americans with Disabilities Act for unnecessarily segregating children with behavioral health needs and failing to ensure they could thrive in a community-based setting. The state settled last November, with Gov. Janet Mills saying her administration and the Legislature will continue to invest in mental and behavioral health resources. 'We all strongly agree that in-community behavioral health services are critical, and we are committed to continuing to strengthen the delivery of those services for Maine children who need them,' Mills said in a statement at the time. While the settlement agreement required Maine to expand the availability of community-based behavioral health services for children, it did not specifically add any of these services to schools. The bill, if funded, 'would provide Maine school-aged children with support they need by meeting them where they are most often, and that is their school,' Gramlich said. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
27-05-2025
- Business
- Yahoo
Reporting work requirements are bad at encouraging work, good at making people sick and hungry
A 'SNAP welcomed here' sign is seen at the entrance to a Big Lots store in Portland, Oregon. (Getty Images) Congress wants to make work reporting requirements in safety net programs harsher and more pervasive to remove supports from tens of thousands of Mainers and use that money to pay for tax cuts that overwhelmingly go to the wealthy. Maine has been down this road before and saw that work requirements take away help from people who need it and don't support work. The congressional bill currently under consideration would make work requirements harsher in three ways. It would: Expand the existing requirement in the Supplemental Nutrition Assistance Program (SNAP) for adults without dependents or a documented disability by increasing the age limit from 55 to 64, which will put 4,000 older adult Mainers newly at risk of losing food assistance. Change the definition of 'dependent' to only apply to children under the age of 7, which will put another 27,000 parents and caregivers of school-age kids at risk of losing food assistance. In total, 31,000 Mainers are likely to lose food assistance under these two changes. Impose a similar work reporting requirement on the Medicaid (MaineCare) program for the first time in the program's history. 34,000 Mainers are likely to lose health care under this change. While some Republicans have sought to portray work requirements as distinct from benefit cuts, the proven reality is these changes will remove millions of Americans from the affected programs, the majority of whom are working, caregiving, or suffering from a serious health condition that prevents them from working. Work requirements create a lot of new paperwork and administrative barriers. According to the Maine Department of Health and Human Services, these would cost $6 million a year in additional administrative costs alone. The extra bureaucratic hoops also lead to the disenrollment of many people who are meeting the requirements but just get caught up in red tape. By one estimate, 13% of people impacted by the congressional proposal would not currently meet the work requirements for Medicaid and don't qualify for an exemption, but the actual number who would lose care is three times higher (39%), meaning that the majority of people losing coverage already participate in the workforce or qualify for an exemption. Approximately one third of Maine workers below traditional retirement age work less than full-time, year-round. In a seasonal economy like Maine's, it can be particularly hard for people to meet a work reporting requirement on a consistent basis every month because the jobs simply aren't available or the hours vary. Many Mainers have health conditions that make it hard for them to work but are not always easy to prove to gain an exemption from a work requirement. As many as 110,000 Mainers aged 18 to 64 report having some kind of disability, but only 30,000 of them actually receive Social Security Disability benefits, leaving tens of thousands of Mainers with a harder time proving their disability to gain an exemption. There are plenty of other obstacles to work that the bill doesn't recognize. A 2021 survey of unemployed Mainers found that one in eight couldn't work due to childcare problems, and 6% didn't have reliable transportation. Finally, it's worth remembering that food and medical assistance are key to health and stability people need to engage in the labor force. Medicaid expansion has increased employment among adults with disabilities and SNAP has also been shown to help people find and keep employment by freeing up money for expenses like childcare. Taking both away from folks who can't find consistent work will only make their barriers to employment worse as well as make it harder for them to get by in general. Maine has prior experience with expanding work requirements that proved unsuccessful. In late 2014, then-Governor Paul LePage expanded work requirements in the SNAP program for adults without a documented disability who did not have children at home. Nearly three quarters of the SNAP recipients who were subject to the new requirements lost their benefits, with tens of thousands losing assistance over the next few years. Many of those who lost benefits were still unable to find work in the year afterwards, and those who did had incomes well below the poverty line. A 2017 survey of Mainers who lost SNAP benefits due to the LePage policy changes found that almost 80% of them had to use food pantries more often after the change, and 86% said it led to them making difficult choices between paying for food and other necessities like rent or health care. National research shows similar patterns in the SNAP program — the federal work reporting requirement makes it much more likely that people will lose food assistance but does nothing meaningful to help those folks find work. Recently several states have experimented with work requirements in Medicaid, with similarly poor results: Under Arkansas' temporary Medicaid work requirement, one in four people subject to the new test lost their health care coverage, most of whom could not get alternative health insurance, and there was no evidence of increased employment as a result. Georgia imposed the work requirement when they expanded Medicaid coverage under the Affordable Care Act. One year into the program, just 2% of people thought to be eligible for the program have enrolled, leaving hundreds of thousands of people unable to get health care. This is despite the state spending millions of dollars on consultants to conduct an outreach campaign. New Hampshire suspended its Medicaid work requirement after it had trouble even notifying impacted enrollees about the change. Despite multiple outreach efforts, nearly half of the people potentially subject to the work requirement didn't even receive notices from the state. Of those assessed for the work requirement, only one third were judged to be meeting it when the policy was suspended. Congress is at risk of repeating the mistakes made in Maine and other states and expanding them to the whole country in its reconciliation bill. Work requirements are efficient at taking food and health care away and creating more costly rules for states, but they don't lead to more people working. Tens of thousands of Mainers will lose access to health care and food assistance and will suffer real hardships as a result. This commentary was originally published by the Maine Center for Economic Policy blog. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
20-05-2025
- Health
- Yahoo
Maine House fails to garner enough Republican votes to make Medicaid funding available sooner
Several legislators said that they've heard concerns from constituents, both those who work in the health care field who are worried about layoffs and those who rely on Medicaid worried about accessing services. (Photo by Getty Images) As health care providers warn of depleted funds hampering services, the Maine Legislature appears poised to close off a path that would make already allocated Medicaid funding available sooner. With a 93-50 vote on Tuesday, the Maine House of Representatives failed to reach the two-thirds support needed to enact an emergency measure. The contents of this bill are already law. The funding was included in the two-year budget passed in March. What's new is that this bill would make that funding available immediately. Democrats pushed through a two-year budget that continued government spending at the same level but also included additional funding to address emergency needs, notably to address a $118 million funding deficit for MaineCare, the state's Medicaid program. However, because that budget bill also failed to garner the support of two-thirds of the Legislature, the funding will not be available until late June. The Democratic majority moved ahead with that plan without GOP support after Senate Republicans refused to support an earlier change package for the current fiscal year to address the MaineCare deficit and other urgent needs unless it included structural reform to the health care program. Legislative leadership accepted a late-submitted emergency bill, LD 1948, as a way to try to get the funding out to providers sooner. 'This bill before us here is just the blank check part without the other reforms that we had agreed to,' House Minority Leader Billy Bob Falkingham (R-Winter Harbor) said ahead of the vote on Tuesday. However, not all members of the minority party felt the same way. Rep. Rachel Henderson (R-Rumford) voted against the supplemental budget because at the time she'd felt that there was an opportunity to push for reform, but she said on Tuesday that the measure before the body was different. 'Now what's before us is, we're asking ourselves, do we want to pay our bills?' Henderson said. 'I would urge my colleagues, let's let the past be the past.' Despite not clinching the support needed, the bill will still head to the Senate for enactment and could return to the lower chamber if the emergency threshold is reached in the upper chamber. The state started withholding some payments to health care providers on March 12 amid the budget debate to ensure some level of funding would be available for the duration of the current fiscal year. Several hospitals said then that they were not in a position to absorb the payment cuts. Now, the total withheld to community-governed hospitals in the Maine Hospital Association is approaching $100 million, Jeffrey Austin, vice president of government affairs for the association, told Maine Morning Star. 'This is a lot of cash to not have available to pay bills with,' Austin said. 'Maine hospitals have some of the lowest margins in the country and the highest debt.' The load hospitals bear gets heavier with each day that goes by without a full restoration of reimbursements, Austin said. 'It's made a tough situation that much tougher,' he said, 'and the sooner it's over the better.' Several legislators said on the House floor Tuesday that they've heard similar concerns from constituents, both those who work in the health care field who are worried about layoffs and those who rely on Medicaid worried about accessing services. 'So when I'm asked, 'What's in it for us?'' Rep. James Dill (D-Old Town) said. 'The answer is simple: people.' Hearing similar concerns in his district, Rep. David Rollins (D-Augusta) acknowledged LD 1948 won't fix all of the financial challenges providers are currently facing, 'but it will provide some relief by ensuring that the providers get the MaineCare funding they're owed by the state.' Speaking with Maine Morning Star, Scott Hanson, president of the Maine Medical Association, which represents the state's physicians, residents and medical students across all clinical specialties, had a similar view of the emergency legislation. While noting challenges with hiring and retention and what he sees as inadequate reimbursements rates, Hanson said MaineCare payments are a crucial part of providers' bottom lines, so having that funding restored sooner is a priority for the association. Regardless, Hanson is concerned about the state of Medicaid, given possible cuts coming from the federal budget being considered by U.S. Congress. 'Things are so, how shall we say, topsy turvy, or uncertain coming out of Washington,' as Hanson put it. The U.S. House of Representatives Committee on Energy and Commerce, which oversees health care, approved a bill last week that proposes the largest cuts to Medicaid in the history of the program. The full House is expected to vote on the package this week and, if it passes, it would then head to the Senate, where GOP lawmakers are expected to rewrite numerous sections of the bill. 'That's going to trickle down to the states as a lack of funding,' Hanson said. 'So it could make the current crisis for Augusta legislators a whole lot worse.' The two-year budget Democrats passed in March did not include any policy changes to address the sizable budget deficit the state faces over the next biennium, including another expected shortfall for MaineCare. Gov. Janet Mills' proposals to close that gap — tax increases and program cuts — as well as the requests from the public and lawmakers are being considered for the next iteration of the budget plan. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
18-05-2025
- Health
- Yahoo
Providers fear Medicaid cuts could worsen Maine's health care access crisis
May 18—Spending cuts proposed by congressional Republicans would result in an estimated 34,000 Maine people losing Medicaid coverage, harming health care providers and patients, experts say. But the current version of the budget proposal is not as draconian as some expected. The bill has the support of President Donald Trump, but its fate is uncertain. Some Senate Republicans are concerned about the impacts of $625 billion in proposed Medicaid cuts over 10 years, while some Republicans in the House of Representatives want deeper spending cuts in general to prevent growth in the federal deficit. On Friday, the bill failed a vote in a key House committee. Conservative House Republicans want certain provisions — such as work requirements for able-bodied adults — to take effect sooner. In the current bill, work requirements would not begin until 2029. But moderate Senate Republicans — including Sen. Susan Collins of Maine — have balked at Medicaid cuts that are also opposed by Democrats. With slim majorities in the House and Senate, Republican leadership can't afford to lose more than a few votes in each chamber and still pass the bill. The entire Maine congressional delegation is against the proposed cuts to Medicaid, or MaineCare as it is known here. Medicaid is a federal program operated by the states and funded with a blend of federal and state dollars. It primarily serves lower-income people, those with disabilities, and some people age 65 and older who receive both Medicaid and Medicare benefits. FIGHT IN CONGRESS OVER MEDICAID James Myall, policy analyst for the Maine Center for Economic Policy, a progressive think tank, said the bill "undermines the whole purpose of Medicaid, which is to keep people healthy." "It's making fundamental shifts in a program designed to help people in hard times," Myall said. "In order to be eligible for Medicaid, it would be contingent on extra hoops (work requirements) people would have to jump through in service of giving more tax cuts to the wealthy." But Chris Pope, a senior fellow and health policy expert at the Manhattan Institute, a conservative think tank, said the bill is not as ambitious as some other ideas that were floated to curtail Medicaid, such as reducing federal matching funds. "A lot of these provisions in the bill are less significant when you look at the details of how they are designed," Pope said. The bill contains loopholes that would permit states to evade many of its so-called requirements, he said. "My general take on this bill is that it's trying to create the appearance of savings. The actual savings are pretty minimal. It's carefully crafted to not do too much," Pope said. Jeff Austin, vice president of government affairs for the Maine Hospital Association, said the proposals that could have the most detrimental impacts on hospitals have so far been avoided, but "there are still reasons to be concerned." The bill introduced in Congress would fund much of the federal government, but most cutbacks in the bill are aimed at Medicaid. The Maine Center for Economic Policy estimates that 34,000 Maine people who are currently enrolled in Medicaid would lose health insurance coverage and be in danger of going uninsured. Many would be eligible for insurance under the Affordable Care Act, but Congress is also considering reducing subsidies that help people afford ACA premiums, which could push coverage out of reach for more people. About 400,000 Maine people are currently enrolled in Medicaid. The number of enrollees grew in recent years, partly because of the pandemic, and the Mills administration and lawmakers are debating proposals to shrink enrollment. Along with reducing eligibility, the federal proposal could substantially increase Maine's costs. The Maine Center for Economic Policy is projecting a $90 million annual reduction in federal Medicaid funding per year, assuming Maine continues to allow children of immigrants and pregnant women who are immigrants to enroll in MaineCare. Maine is one of 14 states that allow children of immigrants and pregnant immigrants to enroll in Medicaid. "This seems to be less intended to generate substantial fiscal savings. Instead, it's putting pressure on states to change their immigration policies," Pope said. HEALTH CARE PROVIDERS WORRIED ABOUT IMPACTS As Congress considers changes to the bill, Maine health care providers said they are worried about any cutbacks to Medicaid, given an already financially strained health care system. Even at current funding levels, Maine is struggling with its Medicaid budget. Maine needs to plug a $118 million funding hole in the current fiscal year, and has had to reduce MaineCare payments to hospitals and other providers to keep the budget balanced. At the same time, the Mills administration and some lawmakers are fighting over cost-of-living increases to direct care workers who are already in short supply. The financial strain is only adding to a crisis in health care access in Maine, with long waits for primary care services and specialty care. Adam Bloom-Paicopolos, executive director of the Alliance for Addiction and Mental Health Services, Maine, which advocates for nonprofit agencies, said MaineCare patients are waiting eight to 10 months for mental health and substance use disorder services. "It's hard enough right now in the current environment," Bloom-Paicopolos said. "There is already a crisis in access to behavioral health services." The access crisis is primarily caused by a workforce shortage — which advocates say is made worse by low pay for direct care workers — coupled with a surge in demand. He said behavioral health is "tremendously reliant" on Medicaid for funding, and they are "extremely concerned" about funding proposals in Congress. It's a similar story for nonprofits that provide services such as group homes and residential support for those with intellectual and developmental disabilities. Laura Cordes, executive director of the Maine Association for Community Service Providers, said the agencies are 100% funded by Medicaid. "We fear any cuts are going to significantly decrease community-based access," Cordes said. Hospitals in Maine are also in a precarious financial position, with birthing centers closing and Inland Hospital in Waterville closing in June. Austin said if more people become uninsured, "they become more reliant on hospital charity care and financial assistance." "Our members currently provide almost $200 million in uncompensated care now. That amount will surely rise if implementation of these proposals results in less coverage," Austin said. Myall, of the Maine Center for Economic Policy, said that more people becoming uninsured would result in health insurance pools with a higher percentage of people who are older and sicker. That drives up the cost of insurance premiums in the ACA and private insurance. Medicaid cuts could be compounded by other proposed cuts to the Supplemental Nutrition Assistance Program, or food stamps. The proposal, if approved, would result in a loss of $97 million in federal funding for Maine, Myall said, primarily by expanding work requirements. If lower-income people have to spend more of their own money on groceries, that would cause a ripple effect in the economy, with people spending less of their disposable income on other items, Myall said. The irony, Myall said, is that both Medicaid and SNAP support working adults, and imposing work requirements will result in fewer people in the workforce. "People are going to be sicker and suffering," Myall said. "Part of the workforce will become too sick to work, and not able to see the doctor because they're not working." Copy the Story Link
Yahoo
17-05-2025
- Health
- Yahoo
Providers warn major Medicaid cuts would strip thousands of rural Mainers of family planning care
Planned Parenthood's office on Congress Street in Portland, Maine. (Photo by Maine Morning Star) Maine's reproductive health providers are raising alarm about the thousands of patients that would be left without care if a proposal to cut off Medicaid funding from family planning providers comes to pass. The U.S. House of Representatives Committee on Energy and Commerce, which oversees health care, approved a massive tax cut and spending bill this week, which proposes the largest cuts to Medicaid in the history of the program, and would leave more than 8 million Americans without coverage. But a part of the bill also proposes cutting off funding to any nonprofit health care providers that offer abortions and receive more than $1 million in Medicaid funding. That means two of Maine's largest family planning service providers, both of whom serve a large number of patients on MaineCare — the state's Medicaid program — may no longer be reimbursed by the federal government for services. Both Planned Parenthood and Maine Family Planning have policies to serve patients regardless of their ability to pay, meaning they would still commit to providing services for patients, they said. Medicaid reimbursements are already lower than what providers receive from private insurance, which means many Maine centers, particularly those in rural areas, are already facing significant deficits. With the likely loss of a major funding stream, these providers are now confronting a fiscal cliff, according to Olivia Pennington, director of advocacy and community engagement for Maine Family Planning, the largest network providing a wide range of services including abortions across 18 centers in Maine. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'This is a clear attack on rural Mainers, on working class Mainers. Folks who otherwise may not be able to access the health centers if their local family planning clinic has to close its doors,' Pennington said. Already, some rural health centers in Rumford, Damariscotta and Dexter can only stay open once or twice a week because of the persistent deficits these centers have been facing, she said. The targeted exclusion from Medicaid funding, which 47% of all Maine Family Planning patients used last year, further jeopardizes the services they can provide, she said. The bill 'segregates abortion providers, and cuts folks off from making us their provider of choice,' said Lisa Margulies, vice president of public affairs for the Maine Planned Parenthood centers. 'There's an intention to destabilize our funding streams, such that we aren't able to fulfill our core mission, and really put us out of business,' she said. The centers' ability to use Medicaid or Title X, a federal grant that supports family planning services for low-income individuals, is already restricted by the Hyde Amendment, a provision prohibiting the use of federal funds to pay for abortions that President Donald Trump reinstated at the start of his second term. Maine Family Planning has been subject to regular audits to make sure Medicaid funding is not used for abortion, Pennington said. It is not clear how Maine's congressional delegation is going to vote on the proposed health care cuts, but during a press conference Friday Planned Parenthood of Northern New England CEO Nicole Clegg said the organization expects them to reject the proposal. 'Based on their long-standing records of opposing defunding efforts of Planned Parenthood and restrictions to reproductive health providers, our expectation is that they would not support any of these proposals moving forward,' she said. In light of the proposed cuts, the providers are hoping the Maine Legislature can help fill the funding gap. They highlighted LD 143, a bill that would provide $6 million a year for family planning services, including routine gynecological exams, testing and treatment for sexually transmitted diseases, birth control, cancer screenings, and gender-affirming and behavioral health care. 'We really see LD 143 as essential for weathering the national storm, sort of weatherproofing our family planning care network in the midst of these potential federal defunds,' Marguiles said. 'It's really critical that the state partners with us in providing care to anyone who needs it.' Both the Maine House and Senate cast initial votes to pass the legislation, but it was placed on the appropriations table where it will compete with many other funding needs for whatever is available as the state faces a substantial budget deficit. SUPPORT: YOU MAKE OUR WORK POSSIBLE
