Maine a Medicaid Model?
Published October 12, 2009 @ 09:00AM PT

The Commonwealth Fund has released new data demonstrating "shockingly wide" health disparities across the 50 states. This is the third annual survey, and one reflecting data from 2007, so expect the overall state-by-state performance to get much worse in the coming years.
What's interesting about the results is the exceptions to the general correlation between states with higher incomes and lower poverty rates also having better resident health. In particular, Maine is singled out for its position in the Top 5 states with good health despite being a relatively poor place. Some reasons? It offers Medicaid to childless adults, a rarity, and requires stringent information sharing among providers in order to track and respond to issues like repeat hospitalizations.
The Medicaid extension seems key here, as efforts like SCHIP have improved the "medical safety" net for kids, yet ever more adults are losing health insurance and going without necessary care. According to researchers, places like Minnesota or Massachusetts that perform well also show "a greater willingness to use government to improve social conditions." Massachusetts has the fewest uninsured adults, with only 7% lacking coverage.
The moral of the story for thinking about universal health care? Besides that we should maybe be looking to Maine and other states for critical best practices?
"The nation doesn't have one system and one reality, it has at least 50 each with its own economic, social and demographic characteristics."
"States cannot go it alone. Health reform is needed on a national level."
(Photo of Greenville, ME by Lee Coursey)
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Comments (5)
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Leigh is a PhD candidate in urban planning at MIT, and a consultant on U.S. Gulf Coast recovery. She sits on the Board of the Allston-Brighton Community Development Corporation in Boston, and has worked with non-profits, foundations and local governments on policies and programs aimed at reducing urban poverty and inequality.
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Yay, Maine! We have a saying in our state: As Maine goes, so goes the nation. It originates from Maine's reputation as an election bellwether in the 1800s. We also have a history of incubating popular, national politicians, ie: George Mitchel, Margaret Chase Smith, etc... The state motto is DIRIGO, latin for "I lead."
While not as progressive as our Vermont cousins, I like to think we do a lot of things right in my state - though not without a lot of effort and internal opposition.
Our Medicaid system is under constant scrutiny and criticism from the Right. While it is flawed, it does what it's suppose to do - provide health care to those in need. My only fear as that opposition garners enough support to remove it instead of take the pragmatic path and work to revamp it so that it's more favorable.
Let's hope the saying and motto are true when it comes to health care as well as this November when we hold referendum on the status of same-sex marriage.
Posted by Jeremy Keith Hammond on 10/12/2009 @ 10:09AM PT
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Like Maine, Minnesota also has a history of leading the nation. To quote Garrison Keillor: "...where all the women are strong, all the men are good-looking, and all the children are above average."
The truth of the matter is, our Medicaid program to assist single adults (GAMC - General Assistance Medical Care) has been unallotted (line-item vetoed or axed from the budget) by Governor Tim Pawlenty.
Many organizations serving and advocates for the poor are working to come up with other ways for people to receive healthcare so that the hospitals don't end up with loads of patients seeking emergency care.
Here's an info sheet: www.ststephensmpls.org/Library/upload/GAMC%20Fact%20Sheet.pdf and video testimonies from people who will be directly impacted by the loss of GAMC: www.youtube.com/user/ststephensmpls09#p/a
There are also protests by the MN Nurses Association: www.youtube.com/watch?v=6PrBexDwEiM
And of course there's local media coverage: www.kare11.com/news/news_article.aspx?storyid=825611&catid=391
Please learn more about the cuts to GAMC in Minnesota.
Posted by Marissa Pherson on 10/12/2009 @ 01:22PM PT
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Told you Maine was a hot spot.
I have to credit to the group who has been quietly educating the right. Then making friends of Maine state legislature to do the right thing. It is Maine Assoc. of Interdependent Neighborhoods.
Or MAIN. Maine itself has a lot of low-income people in it, to act as rubber stamps on what there middle class advocates wants. It stalls dangerous budget cuts when the commissioner of the Department of Human service said back in the 1990's, "Our people Mothers on Welfare, the poor will just tighten their belts."
MAIN had 1,000 people there to paint how badly the grossly underpaid were already hurting. We dodged some real bad cuts.
I have been a member of MAIN since 1986. It is not as truly progressive as the leaders think it is. There is some hidden bias from the head persons. Most leadership are former or current lawyers. And the are like other liberals who say in action or deeds What I personally to mean that the poor are like children.
This prevents them from taking the ideas of the poor as meaningful. This has kept me away from the best group in Maine. Because it refuses to fight the underlining of homelessness.
If one of their lawyers were to file a class action against General Assistance, it could help make the system work as advertised. As stated in the law books. Today the people I try to Aid are told by GA officials, what I Tell my clients are all kinds of Lies.
Mis-communications, or a different interpretation of law is what wussy people call such. "Bad Training" is what the state calls it. But state does part of the training. And the lies which turns away those who qualifies from city to town across this state, seems uniform from town to town.
According to the way big cities and small villages operate, they ignore the fact that State law SAYS People without money can move. Yet while trying to make an application people are told to go back to the towns they came from and apply their.
When I come up from Conn in 1974 I was told by one person, I had to reside in Maine 30 days before the town would help me. I told them I have a right to live where I chose, and I have been in Maine over 30 days. That one person became indiginant and said she was mistaken, that it was 60 days. Laws creating a length of residecay were struck down as Unconstitutional. It happened in Conn. in 1969.
Then this woman said she was Mistaken yet again, That it was 90 day I exclaimed I had been here 90 days when I was about 10 days shy. But she did not look at any book when she made the time length longer. "There is nothing I can Do" She informed me.
On my way out in a stage whisper I muttered I would get a hold of what ever they call legl aid up here. She called me back to make an EXCEPTION, for me.
Even with the state law positively saying their is no length of residency people are told go back to the town you come from for 30 days. MAIN leaders do not see any wisdom in fighting the cause. The leader's react from their backgrounds as lawyers, fighting case by case. Is what I am told they will do.
As best as I can tell, Pine Tree Legal has around 7 -10 lawyers From Kittery ME to Limestone ME. for 150,000 poor people. They cannot go to court for every case.
Now I started off telling you how MAIN was a great organization. That does not mean they can not grow, or improve.
And MAIN is great at what they do. They began a Parent for Scholar's program. Its for welfare people to return to college. So they think the poor are teachable. Its just that MAIN refuses to change for ideas coming up the rank and file. They change only when they see what we are saying makes sense.
This means a great lag time until the leaders make the issue their own idea. Or it must be presented by someone of dynamic personality. Now the parents going back to school thing happened when I took a break from meetings. So it is possible that MAIN the Organization got that idea directly from the poor. Any way it is a hall mark achievement. I had
Folks from Texas call up the Homeless hot line, in 1996 or so to learn more. I gave the Texas Folks the contact information for MAIN. I figure while shouting a groups praises; If there is room for improvement also tell them and the world that.
MAIN could be mad with me, for being this honest But How is any thing going to improve without an deeply Honest inventory?
I have said these things directly to them with a patronizing pat on the head and a "We know Best Dear" For two decades. I will share my personal opinions, with others and see if MAIN can become so outstanding that no other group in any state can touch them.
Posted by jan Lightfootlane on 10/12/2009 @ 02:16PM PT
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Stinking TX Medicaid is only available to the PREGNANT Adults. TX Medicaid should be called the Leave NO Impoverished Crib Empty Act! I hate TX Social Services lack of timeliness and access. I am short on Food, it has been hard on my parents financially keeping me alive, and without Medical Care here. I am too disabled to DRIVE or Work.
I first applied for Social Security SSI in June 2004, and I was determined officially disabled by an Administrative Law Judge June 2006. I received minimal back pay for 2004 2006 suffering in poverty. However, Social Security deemed us financially ineligible since May 2006 when Kenneth became employed by the USPS, because he earned a little over the gross income maximum per month limit for 2 persons to get SSI.
Ken, my husband, separated from me in April 2009, and sends me no financial support whatsoever, as he lost his job, and was even denied Unemployment Benefits. I contacted Social Security in April 2009 wanting to restart benefits, as I have NO income, am unable to work or drive. The only difference between 2006 and 2009; I am in worse health, and am even more debilitated NOW! They told me it had been 2 yrs, too long to automatically resume SSI. They are making me start ALL OVER!!! Will it take 2 more years?!! I Just got a Reconsideration Denial Notice... Here we go, Administrative Law Judge Hearing, again. Not so sure I'll make it for hearing again this time. It is ridiculous. I fear impending homelessness and am already going hungry waiting for Food Stamps. I applied in July 2009... my phone appointment to determine Food Stamp Eligibility is Oct. 22, 2009.
Posted by Rachel Russell on 10/12/2009 @ 05:43PM PT
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Here goes the activist in me. All states are suppose to have Legal aid. They can help you with PROMPTLY receiving the food stamps.
In Maine The largest New England state they have 7-10 lawyers. Every state has legal aid. So Texas might have 12.
See if they know of any groups helping the poor. We have Both MAIN from about 1984. And Maine Equal Justice Partners, More than a decade later.
Mass has another group besides Legal aid in TX its http://www.texasaidnetwork.org/ perhaps they can help or set you up with someone who can. Get a hold of the Attorney General for you state. Or the Commission of Health services. He is the boss of food stamps.
Write an editorial of 100 words to your local news. Telling how bad you are physically and you ate without food wondering if you will still be Alive, or displaced and dead on the streets when your hearing comes through.
Americans think all in need will be given everything tell them that is not your case. You are not fighting just for yourself. You are fighting for every disabled American.
If need be call you churches and tell your story, see if they can help with food. or rent. See if Texas has General Relief. This is something which can be done in ever part of America.
Posted by jan Lightfootlane on 10/13/2009 @ 08:11AM PT
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