MaineCare Expansion


MaineCare Expansion; Signing up

Dan Onion, MD, MPH

Mt. Vernon/Vienna Health Officer


August 1, 2018

A bit of history first. The Federal Medicaid Program (called MaineCare here in Maine) was created when its enabling legislation was passed along with the better known Medicare Program in 1968, just as I was graduating from medical school. Before then, all the low-income patients I cared for as a medical student at Boston City Hospital, were dependent for free medical care at city- or county-run hospitals and their clinics, like Boston City, or community hospitals like those around us here in Mt. Vernon, all of which were committed to providing free care to those patients by acceptance of hospital construction monies dispensed through the Federal Hill-Burton program. All 3 Federal programs continue to this day.

More recently, the Federal Affordable Care Act (politicized by calling it "Obama Care", by many), created two new programs: an expansion of Medicaid to include adults under 65 with current annual incomes of less than $16,754 for individuals, $22,715 for couples, and $34,638 for families of 4 (see full tables below), and a "Market Place" where low-income individuals and families with incomes above those and up to 175% of poverty levels could buy Federally subsidized (discounted premiums) full insurance coverage. Over 70,000 people in Maine are getting their insurance through the latter program now but, because the governor has repeatedly vetoed the Medicaid expansion proposals in the name of saving Maine's 10% cost to do so, Maine people who would be eligible, are now left without access to MaineCare coverage. Nearly 2/3 states in the US are participating. Right now Maine income tax dollars are going for supporting the program in those other states but not here.


Annual Income Federal poverty upper limits



Monthly Income Federal poverty upper limits


Having cared for low-income families and studied the impact on their health if they are without insurance (see Mt Vernon Newsletter, October 2017, p5)) for my entire professional life as well as my work as president of Neighbors Driving Neighbors and as town health officer for Mt. Vernon/Vienna, I know how crucial such coverage is if these folks are to be able to find work, care for their children, and remain productive members of our communities. The children are particularly important. 15-20% of children in Maine are now born into such low-income families! The future of Maine will depend on these kids being healthy and succeeding. They can't do that very easily without their and their parents' health! I don't see anything controversial about such a position. As health officer for the town, I want to do anything I can to help that hole in our population's health insurance coverage for those under 65 who are between 100-138% of Federal poverty guidelines.

Maine passed the Medicaid expansion referendum last November with over 60% of the vote. I helped get signatures to support that. Now I'd like to help any Mt. Vernon resident who fits in that category to sign up for Maine Medicaid (MaineCare). If you are not sure, ask me to help you figure it out. As many may know, the legal team at Maine Equal Justice Partners (MEJP) has taken the governor to court to implement the law as passed. It is going to happen sometime within the next year. Those who apply now will get coverage for medical expenses retroactive to the date of their application. So applying now makes sense. In the meantime, those with other insurance coverage should not cancel that insurance until this comes through.

To learn if you are eligible and how to enroll, go to MEJP at:, or call 1-866-626-7059.

Or contact me at, or 293-2076.

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