By skyforbes 
Mainers need better healthcare. In early November, Mainers bypassed socially conservative governor Paul LePage. They approved a ballot measure that will expand Medicare, extending affordable health insurance to 80,000 low-income residents. But governor LePage is doing all he can to delay transforming the lives of Mainers who are barely getting by. Delay is unacceptable.
This is the sixth attempt to expand Medicaid. The first five attempts failed when LePage vetoed bills that had passed the Maine Legislature with bipartisan support. He has no veto power over this voter referendum, but he has vowed to delay the expansion as much as possible during his remaining year in office. “The truth is that Medicaid expansion will just give able-bodied adults free health care,” LePage said this fall. “‘Free’ is very expensive to somebody.”
Mostly, it will be expensive for the federal government. Under the Affordable Care Act, the federal government will cover 94 percent of the cost for newly eligible Mainers (90 percent after 2020). The state’s legislative fiscal office estimated that expansion will cost Maine about $128 million net over four years. And that calculation doesn’t include savings elsewhere in the state budget. Michigan and Arkansas, which expanded Medicaid similarly in 2013, found overall savings even after the states paid their cost-sharing contributions. Those states paid less to reimburse hospitals for uninsured patient care. Tax revenues increased as healthier workers earned more income.
The Mainers likely to gain coverage are mostly employed but lack access to affordable health insurance, and most live in rural communities. Medicaid expansion has worked especially well in rural states like Maine. It has had a disproportionately positive effect in rural communities: the uninsured rate in small and rural towns nationwide decreased from 16 percent to nine percent in the two years after the Affordable Care Act took effect.
This initiative will also strengthen the finances of the state’s rural hospitals and create as many as 3,000 new jobs. Rural hospitals would receive reimbursement for the care they now provide for free. Their financial markets should stabilize. Safety nets would expand to better support those struggling with mental illness and addictions, providing earlier (and less expensive) interventions for . Rural communities live and die with their service providers: elementary schools, post offices, grocery stores, and hospitals. Healthcare jobs draw educated, well-compensated, and community-minded residents to rural towns. These aren’t just jobs, but good jobs.
Rural communities across Maine are fiercely self-sufficient. For example, they came out in droves to help when a severe storm blew through early November. In Blue Hill, a tree fell across the rotary in the center of town, blocking two major roads at once. Well before the road crews could be dispatched, local volunteers had bucked the logs and cleared the road. The volunteers’ handiwork was visible on roadsides in the downed, browning treetops and piles of sawdust. Neighbors automatically checked in on my widowed mother. We still don’t know which of them removed a tree that had fallen across her driveway. This community quietly watches out for its own.
But community resilience won’t solve rural Maine’s healthcare crisis. Neighbors can’t step in to lower health insurance premiums for the working poor. Instead, they voted to empower the state to help neighbors with their own tax dollars. Support for the ballot measure was strongest in left-leaning communities along the coast and in southern Maine. But it was also backed by voters in conservative northern Maine. LePage’s delay tactics are an affront to these proudly self-sufficient people.