Mills and Lepage Clash on Health Policy

Governor Janet Mills and former Governor Paul LePage answer questions during the first of a series of pre-election governors’ debates on Nov. 8. Derek Davis/Staff Photographer

Gov. Janet Mills and former Gov. Paul LePage have vastly different approaches to healthcare, from the government’s response to the COVID-19 pandemic to fighting the opioid crisis.

The two major party gubernatorial candidates also have a track record of revealing real governing philosophies beyond campaign rhetoric.

Mills, who took office in 2019, had to create the state’s response to the global COVID-19 pandemic. Both candidates have had to contend with the opioid epidemic amid growing fatal overdoses. And both set records for health care reforms, including voter-approved Medicaid eligibility expansions in 2017. she took over.

Sam Hankler, an independent gubernatorial candidate and former doctor, does not hold public office. Hankler says he listens to the people of Maine when formulating state policy, but his website also says he wants to expand treatment for opioid addiction by shifting funds from incarceration. , contains several views on health issues, such as needing someone rescued from a fatal overdose. Choice of prison or rehabilitation.

COVID-19 (new coronavirus infectious disease)

The COVID-19 pandemic began about 15 months into Mills’ term. She and other governors have been judged on their response to the crisis from the beginning.

Governors should review how quickly and comprehensively they enacted COVID-19 restrictions, when they will ease or lift restrictions such as the use of masks and the size of gatherings, how schools will respond, how vaccines will be deployed and taken, and how vaccines will be administered. A number of decisions have been evaluated, including the mandate for

Mills noted the relative success of Maine’s approach to the pandemic, including quarantine orders, mask requirements, mandatory vaccinations for health care workers, and guidance for school districts, and measures such as distance learning and surveillance testing. is encouraged.

Maine has consistently been one of the most vaccinated states in the nation and has one of the lowest death rates from COVID-19, despite an older population.

Scott Ogden, Mills’ campaign spokesman, said the governor’s approach is centered around the philosophy that “the people of Maine are the foundation of our economy, and without healthy people there can be no healthy economy.” Said there was

He said Maine’s “healthcare system outperformed nearly every other state during the pandemic,” according to a report by the Commonwealth Fund, a national foundation that supports health care reform. The book praises Maine’s vaccination program and notes improved access and quality of care under Governor Mills, both of which have been expanded and improved by her administration.”

Mills also pointed to her administration’s efforts to increase the staffing of the Maine Centers for Disease Control and Prevention, which had been severely cut during the Lepage administration before the pandemic struck. The company has gone from 333 employees in January 2019 to 404 last week, approaching the headcount when LePage took over in 2011.

LePage, meanwhile, attacked Mills for imposing overly stringent COVID-19 mandates, such as requiring healthcare workers to be vaccinated and encouraging school closures and a shift to distance learning.

According to his campaign, Mr. Lepage faced no comparable situation during his tenure, but he would not impose mandatory vaccinations on health care workers and first responders, and schools would remain open. I would have made sure that

“Mills’ administration followed the lead of other Blue governors, ignored scientific data, relied on political drama, and aggressively shut down education in Maine schools to ensure that Maine’s children “This misguided policy is costly to an entire generation of children, their economic futures, and to Maine’s economy,” said John McGuff, Lepage’s senior campaign adviser. It created a devastating ripple effect that impacted our overall impact. Governor LePage would have taken a smarter approach and put the needs of Maine’s students first and foremost.”

Schools transitioned to distance learning in Spring 2020, with most schools operating a hybrid of distance and face-to-face classes for the 2020-2021 school year. Most schools have returned to five-day-a-week in-person schedules for the 2021-22 school year.

opioid epidemic

LePage and Mills have taken different approaches to the opioid epidemic.

Overdose deaths soared under LePage, peaking at 417 in 2017 before declining slightly in 2018.

LePage touts steps he’s taken as governor, including increasing the number of agents with the Maine Drug Enforcement Administration and adding photos to electronic benefit cards, allowing welfare beneficiaries to buy benefit cards in exchange for drugs. can be prevented from being sold to dealers.

LePage also called for a 200-bed detox facility to be built at Windham’s Maine Correctional Center, but it was never built. He accuses Mills of sabotaging the project, but prison officials say the project was fixed after he overshot budget by $75 million.

LePage supported some investments to expand treatment and opposed others, but the use of Narcan, a drug used to resuscitate people who have experienced a fatal overdose, I strongly opposed the expansion. In his 2016, he vetoed a bill that would allow pharmacists to dispense drugs without a prescription.

“Naloxone doesn’t really save lives. It just prolongs them until the next overdose,” Lepage wrote in a veto message.

Mills advocates significantly expanding access to Narkan, as well as other harm reduction advocates say will keep users alive so they can seek treatment and recovery. We also support the efforts of Both Mills and LePage highlighted in their campaigns the fact that anti-overdose drugs are now routinely used to prevent fatal overdoses.

“Without the resources allocated by the governor and Congress, the number of overdose deaths will almost certainly rise,” said Ogden, a spokesman for Mills. , 93% of all overdoses in Maine are non-fatal.”

According to Ogden, Mills is pursuing an “all-out-of-the-way” strategy to “help law enforcement work to stop drug use on the streets and keep people from becoming addicted to drugs.” “We are promoting prevention efforts for the disease and distributing naloxone to keep people alive.” , expanding prevention, treatment, and recovery options throughout Maine. “

But LePage attacked Mills’ response to the plague, saying her approach wasn’t working.

“During the pandemic, the Mills administration irresponsibly isolated people suffering from substance use disorders. She scaled back law enforcement efforts to stop the massive flow of illegal drugs into Maine.” said McGough.

LePage also says access to Narcan and other mitigation strategies perpetuates the problem and does not solve it.

If LePage wins, McGuff said, “We will work with drug courts to propose allowing sentenced individuals to spend a night in jail and provide them with the option to recover and detox at Wyndham. ” he said.

Noah Nesin, M.D., medical director of Penobscot Community Health Care in Bangor, which provides a wide range of treatment programs for people with substance use disorders, said Maine’s treatment environment has improved under Mills, but is still going. There is work to be done. Without improved access to life-saving antidotes and improved access to treatment, fatal overdose rates would be much worse, Nesin said. Fentanyl is now so cheap and available that efforts to address this problem have been overwhelmed by the abundant supply of cheap and deadly drugs.

Nesin did not agree to limit access to naloxone, but said LePage was right in signing a bill in 2016 to limit opioid prescribing by doctors. “New information about opioids hasn’t changed the way anyone prescribes them, so I thought it was necessary,” Nesin said.

Extension of main care

In one of its first actions after taking over from LePage, Mills implemented an expansion of MaineCare, allowing about 95,000 additional people to get health insurance through the Maine version of the federally funded Medicaid program. I made it The expanded population represents approximately 30% of Maine’s total population of 325,000 who currently have MaineCare insurance.

The Affordable Care Act was originally created to require all states to extend Medicaid eligibility to low-income individuals, but a 2012 U.S. Supreme Court ruling made that an option. I was. In states that did not expand, some residents earned too little to qualify for the subsidy to purchase insurance, but some residents earned too much to qualify for Medicaid.

LePage is a staunch opponent of the expansion, vetoing multiple initiatives by the state legislature and refusing to implement the expansion even though it was approved in a statewide referendum in 2017. rice field. He argued that even with the federal government covering his 90% of the costs, it would be too expensive to do so. He also torpedoed efforts by moderate Republicans on compromise plans that would have required small monthly payments to enroll.

According to the U.S. Census, Maine’s uninsured rate will drop from 8% in 2019 to 5.7% in 2021, largely due to the expansion of MaineCare. Mills also added adult dental benefits to MaineCare this year, bringing 200,000 adults covered with regular dental insurance.

Proponents believe the expansion will improve the health of tens of thousands of Maine people, providing them with access to preventative care such as breast cancer screening, as well as treatment for common chronic conditions such as diabetes and high blood pressure. It is said that it became

But McGuff criticized the expansion, saying it discouraged adults from working. He said 86% of his in the expanded population are childless adults and 64% are under the age of 50.

“Because MaineCare recipients have limited income (to maintain their MaineCare eligibility), her expansion policy has had a dramatic impact on Maine’s employee participation rate. That’s why nearly every business in the state has a ‘Help Wanted’ sign,” McGough said.

The Mills administration has been criticized for not doing enough to improve reimbursement rates for direct care workers, those who work in mental health and group homes for people with intellectual disabilities.

Nonprofit leaders say reimbursements have increased, but workers can still find better-paying jobs at fast-food restaurants, big box stores and other less demanding jobs.

However, similar complaints about low reimbursement rates were also made by the Lepage administration.

Ray Nagel, executive director of the Brunswick-based Independence Association, which provides group homes and other services for adults with intellectual disabilities, said overall that the Mills administration has made significant strides in funding services. said it was better than the Lupage government.

“We don’t necessarily believe they[the Mills administration]are doing enough. They often don’t include the provider’s perspective,” Nagel said. “But I would say this administration has done a better job of trying to help us.”

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