Human Services/Health Insurance Rate Reform
Policy:
1. General Assistance Reform
2. The Fallacy of MaineCare as a Backdoor to Single-Payer Healthcare Insurance
3. MaineCare Reimbursement
4. Hospital and Provider Reimbursement
5. Child Protective Services to Adopt “Walk a Mile in their Shoes” Report
6. Ratepayer Reform
7. Maine's Certificate of Need Costs Mainers
8. SNAP Works with Proper Oversight
Rationale:
Maine’s General Assistance program unfairly targets rural Maine as a source of funds for urban and suburban areas, with little benefit to those rural towns in return. The General Assistance program will be adjusted to make the system work for all municipalities, not simply larger cities. The welfare state is alive and well in Maine and must be addressed immediately through elimination of fraud along with education and labor training initiatives.
MaineCare, Maine’s Medicaid system for families in need should not be a political football, but it is. In Maine, we mix state and federal funding, and it appears that it is for the purpose of making non-citizens eligible for MaineCare while avoiding federal law that prohibits Medicaid dollars to non-citizens.
There is a two-sided problem to MaineCare that needs to be addressed. First, we in the United States developed a system where Medicaid policyholders subject their service providers to a lower reimbursement rate. This is a form of structural discrimination, as MaineCare coverage automatically makes the holder a second-class citizen in healthcare settings. The people in Maine with legitimate needs should get help. Some providers don’t even accept Medicaid patients. The other part of the two-sided problem is the massive expansion of MaineCare since 2019. People on the far left of the political spectrum refuse to reform MaineCare. Work requirements for able-bodied people is a positive requirement and has been a part of welfare regulation at the state and national levels for decades. Some on the far left oppose work requirements, but in reality, work opportunities give hope and purpose to Maine citizens and families.
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Maine is the same size as New Hampshire, yet we have more than double the number of MaineCare enrollees than the New Hampshire Medicaid system. MaineCare has been used by Maine politicians and a few other states as a backdoor path to single-payer healthcare, instead of adequately covering those in need. This has caused failures of some hospitals, nursing homes, birthing centers, group homes, mental health facilities, and many other provider entities that accept Medicaid dollars. Both providers and other Maine citizens know full-well that the low rate of reimbursement combined with the explosion in the number of enrollees in MaineCare to approximately 400,000 Mainers has caused the system to breakdown. MaineCare is Medicaid. Medicaid is for people in need. Working with Congress, Maine can market other subsidized insurance mechanisms to transition single Mainers without children out of MaineCare in a humane way.
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Maine’s Child Protective Services needs to be under strict rules that seek safer placements for children in state custody. Almost 150 children have died while in the custody of the State of Maine in recent years. As recently as June of 2025, a child died in Lewiston following several direct warnings to the department from citizens who had knowledge of the dangers involved with the placement. As in the past, not enough was done to protect that child.
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The privately-issued “Walk a Mile in Their Shoes” report, authored by the late Bill Diamond is an excellent starting point for positive policy reform. The Libby Administration will seek more assistance from experts from outside the department, and set challenging progress benchmarks for our employees to follow.
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In 2026, you will need a governor who is able to prevent a complete health insurance implosion.
Unfortunately, the legacy of Obamacare is a massive escalation in premiums. This is of course be driven by federal and state public funding constraints. We now know even more about rate escalation, and unfortunately, thousands of Mainers are in for a big increase. The problem emanates from over-reliance on public funds currently used to maintain family health insurance for too many public-dollar insurance recipients. Much of the coming rate increase will also affect private insurance suppliers, and this time it is not going to be a simple double-digit increase for families. The bottom line is thousands of dollars more in premiums for family coverage. In other words, the big increase in premiums required for individuals to add family members to insurance coverage is about to make coverage unaffordable for both the public and the private sector.
The best solution is to enable small businesses in Maine to provide private health insurance for employees in the private market, and to double-down on health savings accounts by providing incentives to affected parties. This private-sector approach comes from income primarily generated by value-added dollars coming from the private sector. President Trump has recently stated that he would like to see public dollars sent to citizens to purchase their own health insurance. The Libby Administration would structure such a move into existing and newly-created health savings accounts, since the digital infrastructure already exists.
Now is the time to begin to rebuild the nation’s savings rate to ward off the devastating consequences of the 20-year gravitation toward socialized medicine. Having MaineCare at a level where 30% of citizens are enrolled leaves Maine in the most vulnerable position in the entire nation.
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​The Libby for Governor campaign believes that barriers to market entry are a big problem in Maine, starting with an ill-conceived Certificate of Need (CON) program. While Maine has scaled back some parts of CON, New Hampshire has fully eliminated the practice, and for good reason. Why should incumbent hospitals be meddling in the purchase of equipment by competitors? Why should new capital expansion for major medical equipment be legally opposed? Restricting supply in any way drives up equipment prices. Suburban and rural medical service providers will tell you that CON drives costs way up while preventing needed competition.
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Federal government shutdowns that threaten food benefits such as the Supplemental Nutrition Assistance Program (SNAP) program are immoral. Food should not be used as leverage to make gains in other policy areas. We know that 12.5% of Mainers currently receive SNAP benefits. The Libby Administration's goal will be to drive that number down to below 10%, not by recommending cuts to the program, but through economic changes and training that promote self-sufficiency. SNAP's current progress toward encouraging the cooking of fresh foods should be encouraged.
