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Sunday, November 12, 2017

ANALYSIS/OPINION:

The voters of Maine gave themselves a Christmas present last week, voting to expand Medicaid under Obamacare, and doing it by referendum to prevent Gov. Paul LePage, a Republican, from taking it away from them. The legislature had tried five times to give such a fine present to Maine voters, and five times Mr. LePage vetoed the present because he said Maine couldn’t afford it.

The governor, citing the authoritative Moody’s Investor Service, says that such an expansion would cost the state $55 million annually by the time it is fully implemented four years hence. In its analysis, Moody’s says the expansion of Medicaid eligibility to Mainers who are not elderly, but have incomes less than 138 percent of the federal poverty rate, would increase Maine’s Medicaid enrollees to 24 percent of its total population of 1.35 million. Medicaid coverage would be extended to an additional 70,000 Mainers, above the 248,000 already on the state Medicaid rolls.


Moody’s observes that with almost a billion dollars in state funding last year, Medicaid “was Maine’s second-largest expenditure item behind education. The expansion will increase federal funding of MaineCare to $2.1 billion, an increase of $525 million, or 32 percent over present spending. Moody’s further warned that the “larger risk” is that Congress could in the future cut or eliminate the 90 percent federal subsidies for the Obamacare Medicaid expansion, which would require dramatic tax increases if it chooses to maintain the coverage. The clear lesson of history shows that once a new entitlement program is established, it is never rolled back.

Maine voters might be saved from themselves yet, because the governor, cheerfully willing to play the Scrooge the Democrats say he is, won’t agree to implement the expansion until the legislature finds a way to pay for it without raising taxes. That’s a high hurdle for a legislature almost evenly split between the parties. Democrats have a five-seat edge in the House, and Republicans have a one-vote majority in the Senate.

“Credit agencies are predicting that fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget,” the governor says. “I will not support increasing taxes on Maine families, raiding the rainy-day fund or reducing services to our elderly or disabled.”

He cites a previous Medicaid expansion in Maine in 2002 that created a $750 million debt to hospitals. But neither that, nor the 2014 financial implosion of nearby Vermont’s Green Mountain Care experiment with a single-payer, government-run health care system, dissuaded Maine Democrats then, nor have they had second thoughts since. State Sen. Troy Jackson, the leader of the Democratic minority in the state Senate, says he is “determined to use every tool at our disposal to ensure the will of the voters is upheld.”

The Democrats in Maine seem determined to test the caution attributed to Alexander Fraser Tytler, an 18th century economist and historian at the University of Edinburgh, that democracy “can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits from the public treasury, with the result that a democracy always collapses over loose fiscal policy.”


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