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Maine hospitals saved $126M during pandemic thanks to MaineCare's coverage expansion

Mainers for Health Care rally outside the State House in 2018. The coalition supported the successful Yes on 2 campaign to expand Medicaid coverage in Maine in 2017.
Robert F. Bukaty
/
AP
Mainers for Health Care rally outside the State House in 2018. The coalition supported the successful Yes on 2 campaign to expand Medicaid coverage in Maine in 2017.

Maine's expansion of Medicaid coverage saved $126 million in uncompensated care costs across Maine's hospitals during the first two years of the pandemic. Those expenses dropped by 26% per year across that two-year stretch.

A recent paper published in the Maine Policy Review connects this drop to the expansion of MaineCare — the state's Medicaid program which broadened its eligibility requirements in 2019. The changes led to the enrollment of an additional 90,000 Mainers by the end of 2021. Dr. Jordan Rhodes — the Director of Research and Policy Analysis for the Maine Department of Health and Human Services who authored the study — said the expansion came at a critical juncture for the state.

"Non expansion state hospitals actually experienced an increase in uncompensated care costs during this time," Dr. Rhodes said. "So what this implies is that if Maine had not expanded coverage in 2019, uncompensated care costs may have actually increased across Maine hospitals during that pandemic rather than decreased significantly."

Uncompensated care is considered medical treatment for which hospitals do not receive payment. This includes bad debt where a patient is unable or unwilling to pay for treatment, and charity care where a hospital does not seek patient reimbursement from the very beginning.

Larger acute hospitals in the state experienced greater declines in uncompensated care costs when compared to critical access facilities — smaller hospitals which service more rural areas. However, critical access facilities generally experienced a more significant decline in charity care costs.

"So between 2018 and 2021, charity care costs declined by about 65% on average, across all Maine hospitals," said Rhodes, "but it declined by about 76% at those critical access hospitals."

Maine's Medicaid program expanded its eligibility requirements in 2019 when the state adopted the provisions made under the Affordable Care Act. Otherwise known as Obamacare, the ACA allowed states to base eligibility for Medicaid coverage of an individual's income alone.

Nick Song is Maine Public's inaugural Emerging Voices Fellowship Reporter.


Originally from Southern California, Nick got his start in radio when he served as the programming director for his high school's radio station. He graduated with a degree in Journalism and History from the Medill School of Journalism at Northwestern University -- where he was Co-News Director for WNUR 89.3 FM, the campus station.