During the months of February and March, I kept seeing articles and editorials in Maine newspapers about whether to expand Medicaid to Mainers who are uninsured OR whether to provide the necessary funding to adults with developmental disabilities who have been waiting for services for much too long.
I kept thinking, "This is a really screwy way to frame this question! Why is it that those who are writing about and discussing these topics are putting these two issues together as diametric opposites? Why is this discussion being framed this way -- as if the pie MUST be sliced so as to either leave out uninsured Mainers from receiving Medicaid or letting Maine PWDs continue to languish on the waiting list? Surely there are other options for funding that don't involve shafting either disabled or low-income Mainers (as if those two groups are separate)."
I have some theories as to why the debate was being framed this way (and that it was a debate at all), and who was benefitting from packaging the issues in this bizarre binary, but nevermind that! Nancy Cronin, the executive director of the Maine Developmental Disabilities Council, has written a terrific editorial that really gets to the heart of the matter in a sensible and articulate way.
In the March 20 "Maine Compass" feature of the Kennebec Journal, Cronin's op-ed, "Expand Medicare [sic] or fund waiting list? Question compares apples to oranges," addresses the question head-on. (Note: Although someone at the Journal gave the piece a title that says "Medicare," the expansion under debate was Medicaid, not Medicare.) Here's how the piece starts:
Should Maine expand Medicaid or fund the waiting list? That seems to be the question. It is a strange question, however, from the point of view of the Maine Developmental Disabilities Council. It’s like asking if insurance should provide coverage for dialysis or for heart valve replacements. It’s not an either/or question and, frankly, pitting one vulnerable population against another one is not helpful or productive for any of those involved.
Cronin outlines the basics about how the waiting list came about and what the real questions are for moving forward, focusing always on the issue of sustainability.
The question, therefore, becomes: How do we obtain enough money to serve everybody who is eligible and in need of the service? Are the conversations happening in the State House regarding the expansion of MaineCare yielding a sustainable answer? Unfortunately, no. If only there were simple answers. In order to adequately serve people with developmental disabilities in Maine, we need to analyze our system of services to find methods that would serve more people at lower cost. This is easier said than done, of course. Those receiving services today might be afraid of how changes would affect their future and security, and those delivering services might fear for the security of their jobs. It is easier and more comfortable to stay within the current system, but it is not more sustainable.
Hop over to the online edition of the Kennebec Journal and read Cronin's essay!
Below is the text of an email from Jennifer Lunden, Maine healthcare activist, writer, and social worker, whom we recently profiled. She played a very active role in the "Cover Maine Now" campaign and is reporting on the most recent developments and what you can do to affect the future outcome of the situation. From: Jennifer Lunden LCSW, LADC, CCS
Dear Everyone: You may have already heard the terrible news. The Maine House was not able to get the two thirds majority needed to override Governor LePage's veto of LD 1066, the act to bring federally funded health insurance to 69,500 low-income Mainers. The vote went strictly down party lines. I believe we were just two votes short. It was a valiant effort by our state's Democrats; and by Cover Maine Now--a coalition that includes many organizations, including my agency, the Center for Creative Healing; and by people like you. On Wednesday, 45 Mainers dropped everything on a day's notice and lined the halls all the way from the House chambers to the Senate, holding signs saying "Cover Maine Now," and handing out placards quoting testimony from people all over the state. But in the end, all of our efforts weren't enough to convince Republicans to break rank from our embarrassment of a governor, who made national news for his latest blunder. (Here's Rachel Maddow's hilarious take on our not so hilarious situation here in the state of Maine.) So. What now? The good news is that the campaign to bring federal funds to Maine is not over. From Cover Maine Now:
"Although approximately 25,000 low-income Mainers may lose their health care coverage and 45,000 will remain uninsured as of January 1, 2014, we can limit the harm by urging our elected representatives to enact legislation that would accept the funds next year. This is why we need to continue our fight and we need to reach out to our lawmakers to hold them accountable for their final votes following the Governor’s veto."
It is important to raise awareness about the vote and to encourage people to share their views with legislators. Please use social networking to do this, and consider sending a letter to the editor. And from Cover Maine Now, here's another idea: Please thank your Representative if he/she voted to cover more Mainers through MaineCare, or tell your Representative you’re disappointed in his/her vote against LD 1066. First – Look up your Representative. Enter your town and residential address and click submit. Then, click on the Elected Officials tab and write down the e-mail addresses of your State Representative (under Maine House of Representatives). Next - Check how he or she voted on the LD 1066 override.
Then – Copy and paste the e-mail below into a new e-mail message, fill in your legislator’s name and add in your name and contact information… then, send it along to your legislator! Finally – Spread the word to keep our fight alive. Send this message along to a few friends and encourage them to take action as well. Thank you! Send the following message to those who voted YES on LD 1066: Dear [Your Representative], Thank you very much for supporting LD 1066, legislation to accept federal funds to provide health care to nearly 70,000 Mainers who need it. I am disappointed that LD 1066 did not succeed, but I hope that you will continue to advocate for accepting federal funds to expand access to health care. Every day that we forgo these funds is a day that uninsured Mainers face the possibility of a financially ruinous medical crisis. Not only is accepting federal funds the right thing to do for our friends and neighbors, it will help support the Maine economy and our hospitals. By accepting the federal funds and providing health care coverage through our state Medicaid program, Maine can reduce overall health care costs and save millions of taxpayer dollars being spent treating uninsured people in emergency rooms. I hope you will keep working to bring these funds to Maine. I want our state to have a healthier workforce and a more competitive economy. Sincerely, [Your Name] [Your Address] [Town/City]
Send the following message to those who voted NO on LD 1066: Dear [Your Representative], I was very disappointed to hear that you did not support the final vote on LD 1066, legislation to accept federal funds to provide health care to nearly 70,000 Mainers who need it. Maine people have worked hard to provide for themselves and their families and deserve the opportunity to stay healthy. Every day that we forgo these funds is a day that uninsured Mainers face the possibility of a financially ruinous medical crisis. LD 1066 represented a compromise among Democrats, Republicans, and Independents that would have brought generous federal funding to Maine beginning January 1, 2014. A large majority of Mainers support accepting federal funds to increase access to Medicaid coverage. Accepting these funds would have saved lives, created more than $350 million in economic activity, created 3,100 jobs and prevented potential tax penalties for large employers. I hope you will reconsider your position on this issue in the coming months. Maine needs to focus on policies that will create a healthier workforce, boost our economy, reduce societal costs and keep our state economically competitive. Accepting federal funds would do just that. Sincerely, [Your Name] [Your Address] [Town/City] And finally, I want to say a special thank you to Republican Senators Roger Katz, Patrick Flood, and Tom Saviello, for breaking rank with their party and expressing their support for LD 1066. It is regretful the bill never made it back to the Senate, where they could have continued to stand up and represent the vast majority of Mainers who want healthcare justice in Maine. We will continue to fight. Onward!
This urgent call to action is from Jennifer Lunden, healthcare activist, and Maine's 2012 Social Worker of the Year. Please make these calls TODAY, yes Sunday, to ensure that the 70,000 low income Mainers get health insurance this year. Information below from Lunden and Maine's chapter of the National Association of Social Workers.
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There is a NEW bill to bring those federal funds to 70,000 low-income Mainers, and it's going to vote on Monday. We are hoping this one will be less objectionable to Republicans, and we need you to call your legislators at home this weekend. Legislators expect to be called at home, and this is urgent. Please read the below, from Susan Lamb, the executive director of the Maine chapter of the National Association of Social Workers for more information.
And thanks for your help.
Lunden
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THIS Monday the Maine House of Representatives will be voting on an important bill LD 1066, An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding.
This bill will provide health care coverage to nearly 70,000 low income (at or near the Federal Poverty Level) Mainers who need it and all of the money for it is coming from the Federal government for the next three years. In years 4 through 10, 90% of the money is coming from the Federal government.
If Maine FAILS to pass this bill, or the Governor vetoes it and the veto is not over-ridden by 2/3rd of the House and Senate, it means that OUR federal tax dollars will go towards paying for this expansion in the 47 states who have embraced it, and not our own. NASW Maine thinks that this is not so good for Maine Federal taxpayers, at any income level.
The legislation would reduce overall health care costs, save millions of taxpayer dollars being spent treating uninsured people in emergency rooms and get hard working, low-income Maine families access to the life saving screenings and treatment that they need.
FIRST, call your legislators at home this weekend. Everyone is at home except possibly the House and Senate Leaders and the members of Appropriations, who are working on the budget. It will rain tomorrow in much of Maine, so that is a great time to “reach out”.
Maine Legislators EXPECT to be called at home by their constituents, and unless a legislator is a personal friend of yours, stick to those who are YOUR Representatives, please. It is burn out season for them.
Please also take a quick moment to call your Representative. First look up your Representative at http://www.maine.gov/portal/government/edemocracy/lookup_voter_info then call them at home this weekend to leave a message with your representative urging them to accept federal funds to provide health care to nearly 70,000 Mainers!
Or, alternatively, on Monday morning, call them at their respective Party offices or at:
(Deaf, hard of hearing, or speech impaired callers can reach the Maine Relay by dialing 711 or use online relay at i711.com.)
1-800-423-2900 for the general mailbox.
House Democratic Majority Office: 207 287-1430
House Republican Minority Office: 207 287-144
Be sure to state who you are, what town you are from and why you believe it's important to provide health care coverage to almost 70,000 Mainers. As always, remember that these folks run for an office that pays less than $22,000 over a two year period, so whatever you say, say it nicely (as I’m sure all social workers do).
Thank you for taking this important step towards bringing health care coverage to the many hard-working Maine families that really need health insurance. Your call this weekend, or on Monday morning can save both lives and money. What a great idea! This must be why 47 states said “yes” to the offer.
A coalition of dozens of health, civil rights, labor, and other organizations have come together to support the implementation of the Affordable Care Act (ACA) in Maine. Proponents say this step will stimulate $350 million in economic activity and create 3,100 jobs in Maine, as well as providing health care coverage to up to 69,500 Mainers who are currently uninsured.
In an email to a disability group in Maine, Jennifer Lunden explained what's at stake and how Mainers can get involved:
A new coalition of concerned businesses called Cover Maine Now! has been working to bring new federal funds to Maine to provide healthcare coverage to tens of thousands of uninsured Mainers. My agency, the Center for Creative Healing, is a member of this important coalition fighting for health justice.
You can help us out by signing this new petition which will go to your state legislators.
Accepting these federal funds will save lives and save money. It's a win/win!
I am so appreciative of your help last year fighting devastating cuts to MaineCare. This is an opportunity to not only restore funding, but to increase it.
Thank you for taking action!
Maine Legislature:
Save lives and save money by covering more Mainers!
Accepting the federal dollars that have already been set aside to cover Maine’s uninsured will benefit all Maine people and boost Maine’s economy.
More Mainers will have health insurance.
Health care costs will go down.
More lives will be saved and people will be healthier.
Maine’s economy will grow.
I call on you to accept the federal funds set aside for Maine to provide health coverage to more than 69,500 Mainers and save taxpayer dollars by fully expanding MaineCare.
To learn more about this bill intended to bring more money into the state for health care and healthcare-related jobs, visit Cover Maine Now! You'll find fact sheets, media releases, and the petition mentioned above, and other information.
Disability Rights Activists Take Action to Preserve Medicaid & Attendant Care
Pennsylvania Cuts Reflect National Issues; Police Brutality,
83 Arrests in Struggle to Save Medicaid in the Keystone State
by Sharon Wachsler, October 16, 2012
As we posted yesterday, disability rights activists from around the country have converged on Harrisburg, Pennsylvania to convince lawmakers to change course on the devastating cuts to Medicaid that are harming people with disabilities.
The protests and efforts to affect change started on Sunday and continue through Thursday (October 18). Today's activism saw 83 arrests and \police brutality that was captured on video (see below).
Yesterday, Governor Corbett refused to meet with ADAPT, though activists attempted to make headway with other key lawmakers, including Senator Jack Corman and Representative William Adolph, but nothing that led to concrete action or meaningful meetings.
ADAPT's website describes what's at stake as a national issue because
Pennsylvania was in the process of "rebalancing" its system to more effectively support seniors and people with disabilities living in the community rather than relying on institutional placement. The state had also become a national leader in allowing people with disabilities to manage their own assistance and utilizing Centers for Independent Living in the provision of home and community based services. The Corbett administration has destroyed much of this progress by cutting funding for Pennsylvania's Medicaid home and community based services and implementing sweeping changes to the state's infrastructure for providing home and community based long term services and supports. ...
ADAPT believes the choice should be clear because the US Supreme Court has determined, in the Olmstead decision, that under the Americans with Disabilities Act people with disabilities have a fundamental civil right to receive community based services and supports from Medicaid as an alternative to being forced into a nursing facility or institution. Furthermore, there is federal funding to make these important changes.
Video description: Harrisburg Police Assault ADAPT Members at the Department of Public Welfare building on October 16, 2012. A four-minute video of many people, most in wheelchairs, at least one blind man standing up, and many male police officers in an enclosed indoor space. There are glass doors that the police seem to be trying to close or pull people through. You can see an unidentified woman get pulled by her pony-tail over a wheelchair and onto the floor, and there is screaming, and then police remove the hat of Joey Tate and also pull him in through the doors by his hair as ADAPT members shout over and over "Nonviolent!" and "No violence!"
Options for Those In PA and Elsewhere to Make a Difference
For those out of state and CAN'T get there in person, here are the most useful actions you can take to make a difference:
Follow National ADAPT and PA ADAPT on their web pages, Facebook, and Twitter. Share their tweets, status updates, pictures, and videos! Ask others to get involved and spread the word, make phone calls (see below), and lend support in person, if possible. (PA ADAPT on FB and PA ADAPT on Twitter.)
If you can make telephone calls, call Pennsylvania Governor Tom Corbett and tell him to work with Pennsylvania ADAPT to implement Community First Choice. Call him at 717-787-2500 (voice). You can also call Dept. of Welfare Secretary Gary Alexander at 717-787-2600 and tell him to meet with ADAPT.
Savannah Nicole Logsdon-Breakstone, a member of Occupy Pittsburgh and a supporter of PA ADAPT who is not normally able to get transportation to ADAPT events suggests some creative ways of bringing attention to the issue: "Share the messages that National ADAPT have been tweeting/sharing. If you can call, call the numbers they list. Take photos holding signs of solidarity, and make videos about why Medicaid is important -- why it matters in your life. When you share photos/videos, tag National ADAPT and PA ADAPT and write what state you are posting from."
If you CAN make it to Harrisburg tomorrow (October 17) or Thursday (October 18), that is very helpful!
You do not have to have experience as an ADAPT protester! Everyone is welcome to help! Here are some ways to be useful:
Show up! Especially if you can come before or during the rally tomorrow. MY MEDICAID MATTERS Rally, scheduled for October 17th, 2012 , Capitol Building, Fountain Entrance, 1:00 pm, rain or shine. If there is inclement weather, we will be meeting inside at the Main Rotunda at 1:00 pm.
Auer says, "For the next two days, being there, being another voice, a body" matters.
"If you're near the train/bus station (Amtrak/Greyhound), directing people how to get to the Capitol is very helpful. Direct them to the Fountain side (the Commonwealth side) because there will be a rally at the fountain." (See below.)
The weather has been cold and the days have been long. If you can bring warm gear (blankets, sleeping bags, etc.), hot food and drinks, that will also be helpful. As always, brings signs, bring your stories, your passion. Be ready to listen to instructions from ADAPT leaders. Bring your phone, camera, video cam to document what happens and to spread the word.
"My Medicaid Matters" Rally Wedneday, Oct. 17, Capitol Building, Fountain Entrance, 1:00 PM rain or shine. (If bad weather, meet inside Main Rotunda). For more info, see PA ADAPT Facebook page.
Please spread the word and get there if you can!
Why should you come to Harrisburg? This legislative session may fundamentally change “Medicaid As We Know It” in ways that we won’t like unless we tell them what we want in any reforms they propose. NOTHING ABOUT US WITHOUT US! We are beginning to see people returning to institutions. We continue to watch the dismantling of one of the country’s best attendant care waivers and the destruction of small, effective community providers. Community Mental Health services are disappearing, and the future of these services are in jeopardy, becoming almost non-existent. When Medicaid is reformed, we better be at that table.
ADAPT spells out ten demands. Governor Corbetts administration must develop an Olmstead plan which does the following (further details on each item are on the ADAPT website):
Engages ADAPT, the state's extensive network of Centers for Independent Living, other disability-led advocacy organizations and legal advocates in the development and monitoring of the plan and its individual components
Shifts Medicaid funding for long term services and supports so that at least fifty percent of those funds support home and community-based services by 2015
Selects and implements the Community First Choice Option
Establishes specific benchmarks and regularly provides public reporting on the state's progress in achieving these benchmarks
Assures that people with the most significant disabilities receive the services and supports they need to lead an independent and integrated life in the community
Changes state rules to allow attendants to perform health maintenance tasks for people who need them as a long term service or support so that individuals who need this assistance can live independently in the community
Leverages the state's network of Centers for Independent Living and other non-profit disability-led providers committed to the independence and integration of people with disabilities
Establishes Medicaid rates that support a living wage for attendants and sustains the community-based organizations that assist people in living independently
Restores the funding systems that local counties use to support mental health and developmental disability programs
Establishes leadership within the state who truly supports home and community based services as an alternative to institutionalization.
What else can you do to help? Share this article! And comment here and on Twitter about why #MyMedicaidMatters to you!
National direct-action disability rights organization, ADAPT, is marching in Harrisburg, Pennsylvania right now to protest severe cuts to Medicaid. The focus of the action is the governor's mansion to bring attention to state cuts that could severely harm people with disabilities.
Like many other states, Governor Corbett's administration in Pennsylvania has proposed cutting Medicaid as a panacea to address the shortfalls in the state budget. When states cut Medicaid, they not only limit services but they cut the jobs of the people who are paid by the Medicaid funds to provide services, supports and basic health care to the state's citizens. ADAPT is headed to Harrisburg to urge him to work with advocates and the disability community to implement Real Medicaid reform that contains spending while it supports the independence and civil rights of people with disabilities and older adults, and saves jobs.
