Steps Toward Health Care for All: progress so far in 2021!

This legislative session was whirlwind and while we aren’t quite finished, we wanted to take a few moments to share some of the progress we’ve made this year

Dental Care: LD 996

One of the biggest achievements is Maine’s new comprehensive adult dental benefit for our MaineCare program, and the big driver of this success is Maine people, who showed up again and again to share their stories and inspire lawmakers to pass this long-overdue benefit. The first bill to expand access to dental care in Maine was introduced 32 years ago! In more recent years, we worked with leaders from the Equal Justice Partner Circle and partners from other organizations focused on oral health to introduce bills in 2019, 2020, and again this year. Each year, legislators and the media heard undeniably powerful testimony at the public hearings from people who are directly impacted by the lack of access to care.

This year, with the support of Speaker Fecteau and many legislative champions, LD 996 passed with unanimous support. Governor Mills included the proposal from LD 996 in her budget “change package.” Ultimately, the policy was funded through that budget and signed into law in early July. Over the coming months, the Department of Health and Human Services will work with a stakeholder group through the MaineCare Advisory Committee to determine the best way to roll out the new benefit and the Department will go through a rulemaking process.

Adult MaineCare members will finally be able to access this life-changing benefit in July 2022. Not only will more than 200,000 people now be able to get dental care, but Maine should generate an estimated economic return of $21.6 million each year. As Ronny Flannery from Southern Maine Workers’ Center said when the benefit passed in the budget, "We all deserve to be able to take care of our teeth. Dental disease can be devastating—from pain, stigma, and mental health impacts, to life-threatening illness. It's time for Maine to fix this injustice, where basic care is denied to so many people. It's time for Maine to guarantee this basic human right.”

Access to health care for all: LD 718

Another big priority this year was LD 718, which would close harmful gaps in coverage in MaineCare and Children’s Health Insurance Program (CHIP) for many immigrants across our state. Due to racist policies implemented by Congress in the nineties, many immigrants are not able to access Medicaid or CHIP. However, Maine chose, with bipartisan support, to continue covering many immigrants until former Governor LePage cut that coverage in 2011. For many immigrants, the only coverage they can currently access is emergency MaineCare, which is extremely limited. Many of our family, friends, and neighbors who are immigrants in Maine go without life-saving medication, screenings, and treatments.

During the pandemic, while many immigrants worked in essential jobs, including direct care, food production, and our hospitality industry, they were more vulnerable to COVID-19 because without health care, they were more likely to have untreated conditions, like heart disease or diabetes, that can make you more susceptible to the virus and to more serious complications from it.

More than 90 people testified in person or in writing during the virtual public hearing for LD 718. Legislators heard stories from people without health care, health care providers, school staff, faith leaders, social workers, and many others describing the many ways our family, friends, and neighbors who are immigrants struggle without health care. With the support of the bill’s sponsor, Representative Talbot Ross, and the leadership from directly impacted immigrant communities, the bill passed out of committee and had a strong vote in the Maine House. Governor Mills included part of the bill in her change package for the supplemental budget. That ultimately passed and was signed into law, expanding access to MaineCare and CHIP for people under 21 and pregnant people, regardless of their immigration status. When that coverage goes into effect, many people will be able to have healthier pregnancies and children and young Mainers will have a stronger start.

Unfortunately, we were not able to include coverage for income-eligible adults in the budget. LD 718 was carried over, so the legislature can continue to consider it in 2022 and we will continue to work to close this remaining gap in coverage. When Mainers voted to pass Medicaid expansion several years ago, they said loud and clear that they want everyone to have access to health care. By passing LD 718, we’ll close the last gap in access to MaineCare for low-income Mainers.

Medicaid estate recovery and more health care wins

Another win in the supplemental budget is a change Maine’s Medicaid estate recovery program. Estate recovery is a process for states to seek reimbursement for Medicaid (MaineCare) benefits from the estates of a Medicaid recipient who has died. It applies to Medicaid recipients who were 55 or older. (You can learn more about Maine’s current estate recovery program here.) With the legislation, only services related to long-term care included for estate recovery, which is the minimum required by federal law. Currently in Maine, estate recovery can be applied to other types of care as well. We’ve seen that since Medicaid expansion was implemented, many Mainers 55-64 were hesitating to sign up: they wanted to be able to pass on a home they’d worked all their lives for to their kids, or other parts of their modest estate. Enrollment for this age group was lower than expected in Maine compared with other expansion states. We hope this change will encourage more low-income, older Mainers to apply for MaineCare so they can get needed health care.

LD 265 was amended, passed, and sent to the Governor. This bill, sponsored by Senator Carney, will extend postpartum coverage for people with MaineCare coverage for pregnant people from the current 60 days to 6 months in January 2022, to 9 months in July 2022, and to 12 months beginning in July 2023.

A bill sponsored by Representative Arford, LD 653, was signed into law and will require clear information for Mainers who lose employer-based health insurance so they know about special enrollment periods on the ACA Marketplace and about potential coverage through MaineCare as well as other key information so they can better navigate their coverage options.

We’ve shared a lot about the importance of reducing racial disparities over the last few years – and especially since Maine had some of the worst racial disparities for COVID-19 in the nation. It will take time and multiple strategies to make real progress on addressing disparities that have taken generations to develop. LD 1548, which was sponsored by Representative Talbot Ross, became law last month and directs DHHS to work with the Permanent Commission on the Status of Racial, Indigenous and Maine Tribal Populations to determine the right levels of funding needed by historically disadvantaged communities to build community-based infrastructure and achieve health equity. A report on that collaborative work will be submitted to the Health and Human Services (HHS) Committee by January 2022 and the Committee can submit legislation based on that report if needed. To really address disparities, we need to know what we are already doing that is meant to reduce them so that we can build on those efforts or push for new ideas.

Protecting reproductive health care for all

Several bills were defeated that aimed to restrict access to abortion care, including efforts to repeal MaineCare coverage for abortion care that became law in 2019. All people—no matter their economic status—should be able to have control over their reproductive health care and decide for themselves whether or not to become a parent, carry a fetus to term, or end a pregnancy. It is fundamental to a person’s autonomy over their own body. This fundamental right is protected under both the United States and Maine Constitutions, but a lack of health care coverage for that care can create significant economic barriers to access, especially for low-income people. That’s why Maine lawmakers passed a law in 2019 requiring abortion care to be covered by insurance, including MaineCare. It was good to see that coverage protected this year.

These are only some of the many health care bills we worked on this year. If you have questions about any of these or about other bills, feel free to reach out to Kathy Kilrain del Rio, our lead policy team member for health care.