Accepting federal health dollars helps veterans receive the care they need - By Rep. Jane Pringle

Our veterans face many challenges when transitioning out of the military. One of those challenges is finding health insurance and with it access to the health care they need.
 

During my time as the director of the Adult Medical Clinics, which provided health care regardless of insurance status, I was surprised by the number of uninsured veterans who were in need of coverage. For some of them, the clinic and other practices that provided free or low cost care, were their best chance at receiving care. But not all who need it are getting care. 

This isn’t just happening in Maine.

According to a recent study by the Urban Institute, there are 1.3 million uninsured vets under the age of 65 across the nation, nearly half of whom have income levels at or below the federal poverty level. Of these veterans, 535,000 are eligible for coverage, but only if they live in a state that accepted federal health dollars to expand Medicaid under the Affordable Care Act.

Because our governor vetoed our bill to provide this coverage in Maine we are not one of those states. As a result, many Maine veterans will be part of the 144,000 nationwide who will go without health insurance coverage.

I believe that failing to provide affordable health care for all of our veterans is a great disservice to those who have served us.

It’s often assumed that all veterans receive the health care they need through the Department of Veterans Affairs (VA). While many veterans are eligible for health care provided by the VA, they still face obstacles to receiving it.

In 2011, of the 2.3 million veterans deployed in Afghanistan or Iraq only 1.3 million were eligible for VA care and only half of those eligible were enrolled.

The reasons for this are many. Some vets either do not know they are in fact eligible or may be unaware of the types of care they qualify for. Even those who are aware of the VA services they can receive, face significant difficulties.

For some veterans, the nearest VA center is hours away, forcing them to take time off from work and arrange for transportation to the center. We are fortunate to have a VA clinic here in Portland. Additionally, these vets may have to wait before receiving this care due to the backlog of requests for VA care.

These are reasons why accepting federal dollars to expand health coverage for over 66,000 Mainers and about 3,000 Maine veterans must remain a legislative priority.

Those who say expanded health coverage is unsustainable need only look at the numbers to realize that the state and federal government programs and private insurance already spend more to cover those who aren’t insured.

This is in large part because those without health insurance delay seeking care or end up waiting until they are so sick they need emergency care or hospitalization. Hospitals do not turn people away in crisis even when they do not have insurance or cannot pay the bill. This is the most expensive way to receive treatment. Studies show that $1 spent on preventive care or chronic illness management saves $7 dollars on emergency or hospital care.

Medicare currently pays part of the cost of free care to hospitals. The Affordable Care Act is taking away those dollars paid to hospitals to use them to pay for the Medicaid expansion so people can get care at the less expensive and better way that people with health insurance are able to get.

The result of not accepting federal money for Medicaid expansion is that we continue to have people, including many veterans, without health insurance. We will continue to have to provide expensive emergency and hospital care for people with no insurance with the cost being shifted to those with insurance. Also now our hospitals will not be paid by Medicare for part of the free care they give. It also results in sicker patients, more lost work, more disability and more deaths.

This is why Maine was projected to save $650 million over the next ten years if we had accepted federal health dollars, according to the non-partisan Kaiser Foundation.

With veterans making up 15 percent of our state’s population, their good health is important to securing a strong workforce in Maine. 

This coming session lawmakers will have the opportunity to vote again on this critical issue. I look forward to working with them to provide a healthy and more stable future for Mainers and our veterans. 

Rep. Jane Pringle, D-Windham, is serving her first term in the Maine House. She serves on the Insurance and Financial Services Committee and is a retired primary care physician and physician educator.