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Aug 17th 2017 4:59 pm Response: #310321 I think that working is a good mandatory choice. It helps when your up moving around and taking care of my family for years
Aug 18th 2017 5:54 am Response: #310325 My experience with chronic health conditions places me in a quandary. I am not healthy or able to work which has already been established by the Federal government. I also have difficulty meeting my monetary obligations. I really need my medications that provide me a somewhat okay existence. I do not know how they would make a person that is unable to work. I also require community assistance. Also what about the elderly that like me are unable to work. I think the Maine government has to help those that are unable to work. There is a responsibility that needs to be addressed to prevent people who are sick from being exploited and abused. Just listening and reading about the way the poor and low income are being presented is a misleading untruth. Please protect us from this abuse. I beg and pray you hear my words. Thank you for your time.
Aug 22nd 2017 11:41 am Response: #310385 I object to some of the work requirements, specifically to parents of children over the age of 6, even if a child has a profound disability that requires ongoing care. MaineCare will not provide assistance with child care or transportation, which may mean that many parents of young children will lose their insurance coverage because they cannot afford child care. Also, work requirements are unlikely to reduce the number of people who need MaineCare because those who work often have no employer-provided health insurance. These work requirements do create substantial additional administrative costs to the state. Furthermore, I suspect that many of the individuals who would be impacted by the proposed changes probably are not even aware of them and might not have the opportunity to submit their comments on this website: (no access to computers, no internet access, etc.). This is just one more attempt by Governor LePage to put the squeeze on the poor people of Maine! Stop him, please.
Aug 22nd 2017 6:20 pm Response: #310401 Re: Maine's request for a 1115 Medicaid Waiver

As a Clinical Psychologist in Maine who works with many families on MaineCare, I believe that Gov. LePage's proposal to require all able-bodied adults ages 19-64 (including those with children over the age of 6 who have a disability that requires ongoing care) to work at least 20 hours per week does not consider the realities of Maine. Maine is a large rural state with very little public transportation and few supportive services for parents and children. With the significant increase in autism spectrum disorders and children with special needs, parents are being called upon to provide therapeutic services to supplement the meager services provided by rural school systems. These parents cannot find appropriate childcare for special needs children and must be at home when school is not in session or when their children are sick. Finding a job with a flexible work schedule, obtaining childcare, arranging transportation to work and childcare (not covered by MaineCare), and paying the cost of childcare (also not covered by MaineCare) are often impossible for Mainers on MaineCare. Please reject Maine's 1115 Medicaid Waiver.

Stephen Koscherak, Ph.D.
Clinical Psychologist
Bar Harbor, Maine
Aug 23rd 2017 10:45 am Response: #310417 A Mainer who is NOT on Medicaid, I am against Maine's proposed changes to the program. I believe that the work requirement will not allow parents with children with severe disabilities to care for their children. The requirement also presumes that suitable jobs are available in Maine to those with disabilities. In addition, the copay at emergency rooms will prevent low-income individuals from seeking help when they need it most. Those suffering from an acute onset of symptoms could be severely penalized.
Aug 23rd 2017 11:36 am Response: #310421 I am not on Medicaid, but many of those who are lack access to a computer or would not feel comfortable about writing a comment on this proposal or do not even know of the possibility. So I am here to speak for them. I live in Maine, in a rural area with a high rate of poverty, very few jobs, and of course no public transportation. I know that many people around me are on Medicaid because when I am in medical offices, I often hear the conversations about billing and insurance when other patients are at the desk. I am extremely concerned about these proposed changes because it's clear that the impact would be that many, many of my fellow citizens and fellow Mainers would lose their insurance. I am especially concerned about those who have children and especially those with disabled children who need more parental time and attention. Childcare is not free, and this new plan would force many parents to leave their children at home alone (with all the attendant risks of physical danger like leaving stoves on, etc., but also higher possibility of drug use and delinquent activity from lack of adult supervision) or lose their insurance. Those are cruel and inhumane choices to give our fellow human beings. For parents with children with disabilities, the risks would be even higher because finding childcare would be that much more difficult. Also, I know from teaching at a local university that many people around here do not have reliable transportation. People living on a very tight budget typically have old cars, which break down frequently, and they do not always have the money to have them repaired. Due to the general lack of jobs around here and the need to travel to get to any that exist, compliance with these new requirements would be impossible for many people -- even many people who ARE hard working (I know that stereotype out there that the poor are all lazy) and DO want to work and don't have children. These new rules would be cruel and would worsen the health and economic issues in Maine, which are bad enough as it is. For the longer term, failure to address the health care needs of our population, especially those of children, will cost the state more money, both in direct costs and in loss of potential and productivity in our work force down the road. Please do not proceed with these proposed changes.
Aug 23rd 2017 5:44 pm Response: #310437 These changes would not work for me because my daughter is disabled as she was born 15 weeks early. She suffers from Epilepsy, Behavioral issues, and is being evaluated for a mood disorder, as a neuropsych evaluation has been requested. She is homeschooled as she also suffers from anxiety and is currently receiving HCT and we are working on getting her separation anxiety, specifically, under control so that I can be away from her. At this time, it is not possible for me to work 20 hours. I go to school year-round, online, full time, and will graduate in May of 2019. Again, I cannot possibly work 20 hours. If I were to find work for 20 hours, the level of care my daughter requires would take up my entire paycheck and set her therapy back, needlessly. Not everyone on Medicaid is trying to take advantage of the system. My daughter and I certainly are not. I simply want to finish my degree, and be able to provide for my daughter, with a high paying job and get her the help necessary for her conditions. As a single parent, I cannot homeschool her, go to school myself, work 20 hours, participate in her therapy, and function myself, as I have fibromyalgia as well. I have not and will not look into that as a disability as many do. I am working closely with my doctor to prevent future flare-ups. I have adopted a vegan diet on his recommendation, I have started a mild exercise program, and am following his orders as closely as possible to avoid any further complications. Things are manageable right now. If I am forced to work 20 hours a week on top of everything else, they will go downhill quickly, and probably one of the first things to happen is that I will lose sleep in order to get everything done, which will just cause more problems, and it is more likely that I will suffer from a flare. It is my doctor's belief that sleep is the most important part of managing my symptoms, with diet and exercise coming in second. I feel much better after tackling these three things, and that I'm on the right path. The worst thing to do, right now, would be to send me to work for 20 hours.

The premiums are also of concern. We live on a fixed income. My daughter gets SSI, which pays for some bills, and I get a stipend from school loans, but I do have to pay that back. My school loans will be maxed out at the end of 2018, leaving me with an amount to pay, so I have to save everything I can from now until then in order to finish my last six classes.
Aug 25th 2017 10:01 pm Response: #310545 The federal waiver that LePage and DHHS Commisioner Mary Mayhew have filed for from the Trump administration through a program designed to allow states to improve Medicaid care and services. But the changes they have proposed for MaineCare would have an opposite effect, potentially eliminating health care for thousands of poor Mainers.
Aug 30th 2017 4:17 pm Response: #310609 To DHHS Commissioner Mayhew:

This is my testimony offered, re: the hearing process invitation for citizen input:

The intent of the Medicaid Law was to help people, so that the people could contribute back
to their communities in positive and enriching ways, thereby making our country America healthy
and strong.

Your waiver, however, if enacted, would destroy these people; therefore, bringing a tearing affect on the integral fabric of their
communities - so going our state, our country!

Your waiver proposal, however, runs completely in a counteractive, illogical, destructive, economically unsound
and cruel, punitive direction; thereby the attempt to nullify the law's ostensible intent. It also runs completely counter
to federal and state laws, in virtually all aspects.

Additionally, your attempt at this move, an end-around the state legislature is so noted, and is not in
any way appreciated!

Regarding this shameful move, I remind you that State Senator Shenna Bellows made it perfectly as she
testified in yesterday's hearing in Augusta, that this waver cannot move along, WITHOUT THE INCLUSION OF AN INFORMED

___________________________________ FURTHER COMMENTS AS TO WAIVER # 1115 PROVISIONS

1) MONTHLY PREMIUMS - For me, my fiancee and my sister, serious financial hardship would be the result, as would
co-pay demands for non emergency uses of the ER.

2) PAYMENTS FOR MISSED APPOINTMENTS - These, too, would be financial set backs, for the slim budgets of my fiancee's,
my sisters and my own.

3) PRESUMPTIVE HOSPITAL ELIGIBILITY - RETROACTIVITY - The termination of such a provision would MOST adversely affect
the health care and the very lives, of the three individuals I have just mentioned.

4) WORK REQUIREMENTS - I am 67, my fiancee is 65 and my sister is 73, all currently retired, and receiving justly deserved Social
Security income benefits. To force any of us to work 30 hours a week is not possible, counter productive in any shape or form; furthermore,
it is indeed punitive and strictly political in nature, running totally in defiance of the intent of the ostensible Medicaid Law!

Additionally, all three of us are disabled, and have been certified and documented as such.

5) ASSET TESTS - Although none of the three individuals do not engage in annuities as part of an investment strategy, the establishment
of sich a prohibitive condition only succeeds in limiting a financial resource now still
Aug 31st 2017 7:01 am Response: #310617 The following comments are being submitted on behalf of clients and others who requested that their comments be submitted at this phase of the process. We hope that you can post each comment individually.
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