Community health clinics struggle with impact of MaineCare cuts

At the Portland Community Health Center, patients pack into a small waiting room to see harried doctors and nurses for primary care services such as vaccines, checkups and to acquire antibiotics for infections.

Increasingly, the patients do not have MaineCare – the state’s name for Medicaid – and are instead uninsured, leaving the health center facing a financial crunch that if not addressed would threaten the clinic’s existence. 

That’s because the dollars-and-cents difference for the clinic between seeing a MaineCare patient or an uninsured patient is dramatic.

From uninsured patients, who pay on a sliding scale based on their income, the clinics would typically receive about $10 or $20 per visit. But if the patient has MaineCare, the state would reimburse the clinic about $150 to $200, depending on what services are provided. MaineCare is a state-run health insurance program for low-income residents funded with a blend of federal and state dollars.

Although it’s not clear whether the administration will support the request, LePage’s proposed two-year state budget would devote more money to primary care reimbursements, providing more than $15 million a year to offset federal cutbacks. David Sorensen, Maine Department of Health and Human Services spokesman, said the agency had no comment on the issue because it has not yet received a formal funding request from the clinics.