{"id":83735,"date":"2025-08-15T03:00:09","date_gmt":"2025-08-15T03:00:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/83735\/"},"modified":"2025-08-15T03:00:09","modified_gmt":"2025-08-15T03:00:09","slug":"mainecare-recipients-wonder-if-theyll-lose-their-insurance","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/83735\/","title":{"rendered":"MaineCare recipients wonder if they\u2019ll lose their insurance"},"content":{"rendered":"\n

Editor\u2019s Note:\u00a0The following story first appeared in The Maine Monitor\u2019s free health care newsletter, Health Monitor, that is delivered to inboxes every other Thursday.\u00a0Sign up<\/a>\u00a0for the free newsletter to stay informed of Maine health care news.<\/p>\n

Since Congress passed legislation this year imposing new work requirements for some Medicaid recipients, The Maine Monitor has heard from readers who were concerned and confused about whether their insurance coverage would change. <\/p>\n

None of them had heard anything from the federal government about their status, although one received an email press release from the Social Security Administration that said it was \u201ccelebrating the passage of the One Big, Beautiful Bill, a landmark piece of legislation that delivers long-awaited tax relief to millions of older Americans.\u201d<\/p>\n

We decided to take three of their stories to health policy experts for insight. The experts could not provide definitive answers on any individual\u2019s eligibility, but rather gave a general overview of their understanding of the new rules.<\/p>\n

Here are the three profiles we collected:<\/p>\n

Family 1<\/p>\n

A 46-year-old woman who qualifies for Medicaid, which covers her psychiatrist, physician, counselor, medications and physical therapy related to her genetic disorder. She also qualifies for Medicare and Social Security Disability Insurance. She has not worked since a 2023 relapse. She receives $1,187 a month from disability, which is her only income.<\/p>\n

Family 2<\/p>\n

A 74-year-old woman who is raising her 15-year-old grandson, both of whom are on Medicaid. She also qualifies for Medicare and Social Security Disability Insurance. She receives supplemental insurance from Medicaid through the Qualified Medicare Beneficiary program. Her grandson is fully covered by Medicaid and receives counseling, medication management, case management and 3 medications. Their household income is $1,400 a month in social security and $400 from a pension. They also receive SNAP benefits.<\/p>\n

Family 3<\/p>\n

A 38-year-old woman and her 13-year-old daughter are both on Medicaid. The mother previously made about $12,000 a year when she worked, but she is currently in school with assistance from the Temporary Assistance for Needy Families program. Her brother, who is 36, also is on Medicaid. He also qualifies for Social Security Disability Insurance due to a diagnosis of autism. He hasn\u2019t worked since 2023. His income is $1,283 a month, from disability. All three receive SNAP benefits.<\/p>\n

Here is what the experts said:<\/p>\n

Robin Rudowitz, vice president at KFF, a nonprofit health policy research organization, and director of the Program on Medicaid and the Uninsured, said many of these individuals likely would not be subject to the new work requirements because they are also on Medicare, over 65 or a low-income parent.<\/p>\n

The new work requirements only apply to people in the Medicaid expansion population. States that opted into Medicaid expansion as part of the Affordable Care Act extended eligibility to include nearly all adults with incomes up to 138 percent of the federal poverty line ($21,597 for an individual this year), increasing those who are eligible beyond the mandatory groups that include low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income.<\/p>\n

Nearly 400,000 Mainers are covered by MaineCare, the state\u2019s version of Medicaid, and about 90,000 Mainers of them are in the expansion group.<\/p>\n

Under the new work requirements, adults ages 19-64 who got coverage as part of the Medicaid expansion must log 80 hours a month of work, volunteering or half-time educational programs. The state has estimated the new rules will result in 31,000 Mainers disenrolling due to documentation hurdles and the unpredictable or seasonal nature of Maine\u2019s heritage industries. The requirements will go into effect on Jan. 1, 2027.<\/p>\n

There are exemptions to the work requirements for parents of children 13 and younger, those who are pregnant or postpartum, and the \u201cmedically frail.\u201d Medically frail includes people with physical, intellectual or developmental disabilities, substance use disorder, a \u201cdisabling\u201d mental disorder and \u201cserious or complex\u201d medical conditions, according to KFF.<\/p>\n

Dr. Patrick Connolly, a family physician at Martin\u2019s Point and co-chair of the Maine Medical Association legislative committee, agreed that most of the people The Monitor spoke to likely would not be subject to additional work requirements. But their confusion about their coverage still presents a barrier to care, he said.<\/p>\n

\u201cYou have these three case scenarios and they\u2019re worried that they might lose their health care,\u201d Connolly said. \u201cThat worry in and of itself presents a barrier: \u2018I\u2019m not sure I want to go to the doctor (because) I may not be covered.\u2019 \u201d<\/p>\n

Medicaid applications are already \u201ccumbersome\u201d so the more complicated the government makes it, the more likely people are to fall through the cracks, he said. In addition, the legislation passed by Congress is estimated to cut $186 billion from SNAP funding through 2034. People already are having to choose between eating and taking their medicine, Connolly said.<\/p>\n

The result will be patients will wait longer to visit their doctors, or won\u2019t go at all, and will end up in the emergency department, he said. Maine already has among the highest rates of emergency department visits in the country.<\/p>\n

\u201cIf you put up artificial barriers \u2014 the barriers of lack of coverage or the worry of lack of coverage \u2014 people are going to be sicker and we\u2019re going to spend more in the long run because the complications cost way more to treat than the problems upfront,\u201d Connolly said.<\/p>\n

We need your help right now to support our nonprofit, independent journalism <\/p>\n

The Maine Monitor is a critical part of the Maine news network \u2014 doing the deliberate, in-depth reporting that unravels the tangle of an issue, lays out the facts, and gives you a comprehensive understanding of what is happening and what the implications are.<\/p>\n

Our thorough, fact-based journalism drives conversations, inspires people to get involved and informs community decisions.<\/p>\n

During our Summer Fundraising Drive, we need to raise $50,000 to support our newsroom in the last quarter of 2025. Will you donate<\/a> and make more stories like these possible?<\/p>\n

\"headshot Rose Lundy<\/p>\n

Rose Lundy is a senior public health reporter for The Maine Monitor, with a focus on Maine\u2019s aging care system. She is passionate about stories that highlight systemic problems affecting the most vulnerable in our community.<\/p>\n

Rose was previously a 2022 ProPublica Local Reporting Network fellow and a 2020 Report for America corps member. Before that, she was a reporter for three years at a daily newspaper in southwest Washington state. She now lives in Portland, Maine.<\/p>\n

Her work has been recognized by the New England Newspaper & Press Association, Maine Public Health Association, National Newspaper Association Foundation, Local Independent Online News (LION) Publishers and Maine Press Association.<\/p>\n

Contact Rose with questions, concerns or story ideas: gro.r1755226243otino1755226243menia1755226243meht@1755226243esor1755226243<\/a><\/p>\n

Language(s) Spoken: English<\/p>\n","protected":false},"excerpt":{"rendered":"Editor\u2019s Note:\u00a0The following story first appeared in The Maine Monitor\u2019s free health care newsletter, Health Monitor, that is…\n","protected":false},"author":2,"featured_media":83736,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253,53148],"class_list":{"0":"post-83735","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare","11":"tag-the-latest"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/83735","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=83735"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/83735\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/83736"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=83735"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=83735"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=83735"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}