Is MaineCare expansion dead?

Phil: While I appreciate my fellow state Senate Republicans Tom Saviello of Wilton and Roger Katz of Augusta for proposing an alternative to the partisan Democratic plan to expand welfare to tens of thousands, can you explain how their plan will be more affordable than the rest?

Ethan: The feds cover 100 percent of the costs for three years, and then the Legislature decides if we keep the coverage when the feds reduce their portion to 90 percent.

Phil: You spent too much time in California last week watching movie stars.

Ethan: Now that you mention it, I actually took a spin class with Republican President Fitzgerald Grant from “Scandal” (a.k.a. Tony Goldwyn)! I’ll bet he would vote to expand health care.

Phil: You may not have realized this, but he is an imaginary Republican.

Ethan: He wasn’t imaginary when he was chatting up my wife!

Phil: Can you blame him? Anyway, a real Republican would account for the millions in start-up administrative costs that are not covered by the feds.

Ethan: No problem. The non-partisan fiscal office of the Legislature actually showed that those costs will be covered due to the implementation of the managed care system proposed in the Republican bill.

Phil: Right. Projected savings will cover start-up and ongoing administrative costs. But then, after those first three years, the spending will go on and on and on…

Ethan: Not necessarily. That’s for the people who elect the 128th Legislature to decide.

Phil: Are you trying to convince me that a future legislature will actually cut costs by terminating a program? Give me a break.

Ethan: If you’re asking whether I think the Legislature in three years will end health care for 70,000, I certainly hope not. But no legislature can bind another, and the Republican bill requires an affirmative vote to keep the expansion in place. If LePage is re-elected or Republicans gain control of either body, you’ll be able to take away health care from as many people as you wish.

Phil: It sounds like you like the compromise. I thought you were for the plan by House Speaker Mark Eves?

Ethan: Love the speaker’s original plan. Cost effective. Creates jobs. Provides health care. That said, I would vote for this alternative. It’s the kind of compromise I appreciate. It fully expands health care, which my side wants. And it fully implements managed care, which your side wants. My only concern is that the compromise does not appear to be bringing any new votes.

Phil: Not only is it not garnering new support, it actually lost Republican support in the Health and Human Services committee. Rep. Carol McElwee, R-Caribou, voted for the expansion last session but just voted against it this week. Let me be the first to predict that the expansion is now officially dead.

Ethan: Don’t give up hope yet! After all, if she can flip-flop that way, maybe a few others will flip-flop back. After all, you Republicans sure did a lot of flip-flopping last session.

Phil: Or maybe she and many others have finally realized the math simply doesn’t add up? Or perhaps she noticed that the calls she was getting to support the bill were all coming from your district in Portland and not hers in Caribou.

Ethan: Are you saying that she isn’t listening to the 4,600 people in Aroostook County who would get health care based on this expansion and the 280 new jobs it would create?

Phil: I’m saying she understands that raising taxes to pay for this expansion is not healthy for Maine.

Ethan: Your Republican colleagues aren’t suggesting that taxes get raised. Just the opposite. They have proposed a bill that pays for itself.

Phil: Hope is not a strategy when it comes to paying the bills. The costs to expand welfare are in the hundreds of millions over time, and about a million of that begins right away. How do you propose to address the negative cash flow while we wait for the “savings”?

Ethan: No waiting needed. The savings all occur in the first year and cover the costs for year two and three.

Phil: You forget that the bills are paid in cash, and the “savings” come from spending less than anticipated. How about addressing the financing straight up? Present it to the Legislature and see if it passes.

Ethan: That’s what they’re doing!

Phil: No, they aren’t. And that’s why this bill will ultimately fail. Those who want it to pass have failed to tell us what tax they are going to raise and/or what expenditure they are going to cut to pay for this plan in both the short and long term. No more speculation.

Ethan: Up to 70,000 people can get health care coverage for three years with virtually no cost to the state and no raising of taxes. Not much speculation there. But if your guys reject it again and this proposal is dead on arrival as you predict, I will predict heavy consequences for your party this November. Health care is popular and needed.

Phil: Perhaps. But my hope is my party stays focused on on the consequences of this decision well beyond November. The consequences for five, 10, 15 years down the road when the bill comes due.

Ethan: Same here. But the bill I am concerned about is the one we’ll pay due to the thousands who still don’t have health insurance.