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Republican Lawmaker Leads New Medicaid Expansion Proposal

State lawmakers have launched yet another attempt to expand Medicaid health care benefits to 70,000 Mainers, including hundreds who are struggling with opioid drug addiction.

Republican Sen. Tom Saviello says his plan will rely on $6 million in state money that would draw down $420 million in federal matching funds.

Saviello says his plan to expand Medicaid coverage has a backstory.

“Without getting into the details, I have been touched deeply by the loss of an individual who was addicted, that’s my passion in this,” Saviello says.

This is the sixth attempt in the last few years to expand Medicaid, and Saviello is supported by an influential coalition of groups including the Maine Hospital Association, the Maine Chiefs of Police Association and the Maine Sheriffs Association.

While critics of the bill’s funding mechanism say it’s too expensive, Saviello says Maine is already paying for these services in many different ways.

“We can create savings in Maine’s state budget by enhancing federal funds instead of state funds to provide cost-efficient coverage for a full continuum of substance abuse, mental health treatment and preventive care to Maine people,” Saviello says.

“We know that there are barriers that prevent many people from accessing the necessary treatment to turn their lives around. The result is a costly cycle in and out of jail and a significant drain on the resources of our criminal justice system,” says Sagadahoc County Sheriff Joel Merry.

Merry, who also serves as president of the Maine Sheriffs Association, says other states are using the federal programs recommended under Saviello’s bill to provide treatment as a way to reduce drug-related crime and jail sentences for addicted offenders.

“Nobody wants to pay the cost of incarceration and we know that it’s expensive, yet when we look at what is making up our daily population in the state’s 15 county jails, we know that 60 percent have substance abuse issues and that over 40 percent suffer from some degree of mental health problems,” Merry says.

Saviello says studies from other states such as Colorado, Ohio and Michigan show criminal justice savings of between $5 million and $13 million annually as the result of drawing down the federal funds for drug treatment. But that’s not the only segment of the state’s uninsured population that supporters say will benefit from the bill.

Connie Coggins, CEO for HealthReach Community Health Centers, says health care offices in towns such as Bethel, Bingham and Rangeley would also receive much needed funding.

“We are proud to serve all patients at our community health centers, but the reality is that doing so creates financial challenges in caring for uninsured and underinsured,” Coggins says. “Maine has an opportunity through LD 633 to create more access to primary and preventive care and to help people struggling with substance abuse disorders.”

“People have argued that this is free to the state of Maine,” says state Health and Human Services Commissioner Mary Mayhew. “It has a price tag of over $300 million to the state alone.”

Mayhew didn’t cite the source of those costs, but she and Gov. Paul LePage are convinced expanding Medicaid will do anything but deliver savings for Maine taxpayers. She says that while lawmakers attempt to once again grow health care for the poor, they turn their backs on the elderly and disabled who have no other options.

“We saw last year in our biennial budget where we came forward with proposals to increase funding for nursing facilities, to take people off of wait lists who have intellectual disabilities, and the Legislature could not fund those priorities,” Mayhew says.

Meanwhile, Saviello’s Medicaid expansion bill will need two-thirds support in the Maine House to fend off a certain veto from the governor. Republican Rep. Deb Sanderson of Chelsea says that’s not likely to happen.

“I think you’re going to have the same result as we have had in the last five times they’ve tried to push this through,” Sanderson says.

But Saviello says that nearly 60 percent of Mainers support expansion. That’s according to a poll he paid for himself.