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Debunking — Again — Gov. LePage’s Claim That Medicaid Expansion Threatens People With Disabilities

Maine voters will consider a ballot initiative next Tuesday to adopt the Affordable Care Act’s (ACA) Medicaid expansion and provide coverage to 70,000 low-income Mainers. Gov. Paul LePage opposes the measure and continues to say that expansion would jeopardize care for Medicaid beneficiaries with disabilities. That’s false — as we, along with fact checkers and independent analysts, have explained.

At issue are states’ options for providing home- and community-based services (HCBS) through Medicaid to seniors and people with disabilities, usually as an alternative to nursing home care. All states take one or more of these options, but they can decide which HCBS to provide and how many people can receive them. While some states have waiting lists for HCBS, there are no waiting lists for Medicaid coverage; states must enroll all eligible beneficiaries, including children, seniors, people with disabilities, and adults, in coverage — without exception.

Opponents of the ACA and its Medicaid expansion have tried to connect HCBS waiting lists to states that have adopted the expansion, but there are no connections. Most states have had waiting lists for HCBS since before the ACA. Moreover, nine of the 11 states without HCBS waiting lists are expansion states, and the two states with the longest waiting lists are the non-expansion states of Florida and Texas, a Kaiser Family Foundation report shows.

Congressional Republicans encountered significant pushback from state officials of both parties, analysts, and fact checkers when they tried to connect the Medicaid expansion to HCBS waiting lists during the ACA repeal debates earlier this year. In July, in fact, Ohio’s Republican governor, John Kasich, blasted Vice President Mike Pence for suggesting that 60,000 disabled Ohioans are on a waiting list for services that was caused by his state’s Medicaid expansion. This accusation is “false, and it is just the opposite of what actually happened,” Gov. Kasich’s spokesman said.

When Maine voters head to the polls on Tuesday, they’ll have the opportunity to extend Medicaid coverage to more than 70,000 residents. Gov. LePage says he opposes expansion because it would take “resources away from our most vulnerable Mainers.” His scare tactics are just an attempt to obscure how well Medicaid expansion is working in other states and the far-reaching benefits it would bring to Maine.