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My Turn: Advice from Maine: Don’t follow our lead on Medicaid expansion

When I heard that New Hampshire was considering an expansion of its Medicaid program under Obamacare, the first thought I had was a quote from Dante’s “Inferno : “Abandon all hope, ye who enter here.”

I say this as the Republican leader in the Maine House of Representatives and as someone who has served on my state’s Appropriations Committee, where we spent countless late nights trying to patch the Medicaid-induced leaks in our state budget after past expansions.

Maine and New Hampshire are very similar in terms of geography, culture and population size. They are very different, however, in terms of economic policy. It wasn’t always this way. Decades ago, Maine took a decidedly sharp left turn, heading in the direction of more government programs and higher taxation. New Hampshire avoided the income tax, the welfare state and other trappings of big government.

Despite starting out in similar situations decades ago with roughly equally-sized private sector economies, New Hampshire has rapidly outpaced Maine according to almost every economic indicator.

New Hampshire’s median household income is about $65,000 to Maine’s $48,000. Your unemployment rate has been among the lowest in the country since the recession. Liberals in Maine like to tout welfare programs that are designed to reduce poverty, but our poverty rate is 58 percent higher than yours, despite Maine’s ranking second in the nation for welfare spending as a percentage of overall state spending.

It’s interesting how liberals in Maine make excuses for New Hampshire’s success while liberals in New Hampshire make excuses for Maine’s failures.

We’ve made a lot of positive changes here in Maine thanks to Gov. Paul LePage and a Republican legislative majority in 2011-12. Those reforms began to lower taxes, trim regulations, reform welfare and bring some fiscal sanity to Augusta, and people are starting to take notice. But there’s a long way to go.

Mainers are hardworking and independent-minded people, and they’re sick of economic stagnation. I’m confident we’ll stay on the right track.

In fact, our competitive advantage with your state would be greatly enhanced if we managed to resist Obamacare’s welfare expansion while you embrace it.

Over the past 10-20 years, Maine has taken the bait of federal matching funds and expanded its Medicaid program considerably while New Hampshire has declined the money and its attached strings.

All of the promises of Medicaid expansion have fallen flat. Emergency room usage goes up, not down, with Medicaid coverage. Charity care provided by our hospitals has tripled. Federal matching rates have been slashed. Physical health outcomes are no better. Cost and enrollment levels were not manageable; instead, expansion shattered its original cost estimates.

What this has meant for Maine’s budget, taxpayers and economy is very tangible. Maine’s total income tax revenue collected equal the difference in cost between Maine’s and New Hampshire’s public welfare departments. So if our Department of Health and Human Services was the size of yours, we could eliminate our income tax.

Medicaid’s share of the state budget has doubled since 1998 and now sits at 25 percent of all state spending. By 2024, medical welfare will consume 36 percent of our budget. State aid to municipalities is under siege, taxes continue to go up, and politicians have even raided oil spill cleanup funds to plug the perennial budget gap in our Medicaid program.

I understand that the proposal being considered in Concord uses federal Medicaid expansion funds to expand subsidized private coverage on the exchange.

That’s a better deal than the one originally offered by the feds under ObamaCare, and you can credit Republican leaders in your state Senate with that.

But it’s still an expansion of state government and a major strain on taxpayers over the long term, similar to what we’ve experience in Maine, and I would caution you to avoid it.

The most important thing to remember, as citizens of the Granite State, is that the “New Hampshire Advantage” is not by accident; it is by design. Your elected officials have made good economic decisions over the years and it has paid off.

Maine has gone down the path of Medicaid expansion before. Take it from me. You don’t want to follow us.

(Kenneth Fredette of Newport, Maine, is the Republican leader in the Maine House of Representatives.)

Legacy Comments13

a MUST READ: History of Medicaid Expansion in Maine Foreshadows Failure. .... " The promises of reduced uninsured rates and lower charity care simply did not come to fruition..... "

I get the same feeling toward this editorial as I do toward people who review products at and say "Don't buy this." Review the product, tell me what you liked and didn't like about it, but don't tell me what to do. I can make up my own mind, thank you. These kind of reviews always make me wonder about the reviewer's hidden agenda. Why are they so interested in making sure no one buys a particular product?

For me the Review Products Forums are terrific. No matter what you happen to be buying. I want to know if a product does what it is suppose to do, holds up with wear and tear, and basically is worth the price. I appreciate folks giving honest reviews and it helps me decide what I need to buy. Medicaid expansion needs to be looked at in the states that have implemented it. That gives us an indication if it works, cost, network size, etc. You can also make the argument that folks who have a political agenda do not want to hear anything negative about an issue they support. Basically it boils down to if you believe what you are being told. For me, most politicians lie, so I prefer to hear all sides of an issue.

Maybe you should spend more time paying attention to what is really going on in your own state. Especially some of your loud mouth pro rape politicians.

I didnt know Bill Clinton was from Maine ?

Now, now, I hope that you don't treat guests at your home that way.

Facts please, not party propaganda. The failures cited over and over again all point at the reason why we need a single payer system in place in this country, instead of the failed free markets approach to everything that Republicans push as their answer to all of the problems society faces.

HERE ARE THE FACTS YOU REQUESTED: "charity care and bad debt at Maine hospitals grew over 220 percent from $67 million to $215 million between 2002 and 2011 after Maine expanded Medicaid for childless adults in 2002"

OH NO! Not Heritage and Jim Demint again!

straight out of the democrats playbook. When you cant debate the FACTS - skewer the messenger - a truly sad way to operate

Well, advice from Maine. Let's hear what Vermont and Mass has to say.

Medicaid expansion means more free care paid for by producers and more people on the public dole. Don't need it people need to start paying their own way. If you are truly needy, well no problem.

Define "truly needy," please. Making less than $15,000 a year is not needy, when it comes to health insurance?

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