MaineCare is intended to be a safety net for low-income Mainers. The proposed supplemental budget now under consideration in Augusta cuts large holes in that net, with significant consequences for all of us.

Let’s put a face on the program. “Ann” is a single mother of two. She works full time for minimum wage and is studying computer science at a community college. Ann has battled mental illness, but she is in recovery and takes her prescribed medication regularly.

Ann’s employer offers health insurance, but the $500 per month contribution for a family policy is nearly half of her take-home pay and thus not an option. With an income far below 200 percent of the federal poverty level for a family of three, Ann currently qualifies for MaineCare as the mother of eligible children. She is also an example of one of the 65,000 Mainers who would lose their coverage.

And losing that coverage means losing the medication and treatment that has allowed her to recover from her illnesses, work full time and study for a career. That’s not just Ann’s loss; it’s a loss for all of us.

The Maine Legislature is facing very difficult decisions. The current proposal seeks to balance the budget for the Medicaid program through a series of program cuts, reductions in payments to providers and elimination of coverage. It’s important for Maine people to realize that these proposed cuts are in addition to the efforts that providers have already taken to improve value and reduce costs.

MaineHealth, for example, recently invested in an electronic health records system that ensures that patients and providers have timely access to their health records at all of our member hospitals and medical offices, saving time and money and improving patient care.

And Maine Medical Center, the state’s largest hospital, is committed to reducing its cost by $23 million in the next year alone.

These latest proposed cuts could not come at a worse time, which is why as leaders of Maine’s largest health system, we are compelled to explain the very real impact of this budget.

• First, MaineHealth’s member hospitals will face payment cuts of over $36 million. Despite these challenging economic times, we have done everything in our power to maintain jobs and services, but we have run out of alternatives. The proposed cuts will result in job losses, reduced access to community-based services for patients and a halt to many of the very investments that improve quality and reduce costs further. Every Maine community we serve will feel these losses.

• Second, like Ann in the example above, tens of thousands of our neighbors will lose their coverage, but their health care needs will not go away. They still will have mental illness. They still will have diabetes. They still will have cancer.

In 2014, the Affordable Care Act, which implements our nation’s health reform agenda, will require Medicaid to provide coverage to uninsured individuals who fall below 133 percent of the poverty level. If we eliminate their coverage in the meantime, any savings will be short-lived while our long-term costs will skyrocket as illnesses go untreated and preventive care is not received.

• Finally, another casualty of the proposed cuts is elimination of prevention programs that have been supported by the Fund for a Healthy Maine. These include critical preventive services such as immunizations, dental care and the Drugs for the Elderly Program, which ensures that low-income seniors and people with disabilities have access to life-sustaining medications. All are vital components of Maine’s public health infrastructure.

The proposed budget — and any other proposal that seeks to solve this long-standing budget problem through reductions solely within the Department of Health and Human Services — will have major consequences for all Maine communities.

MaineHealth strongly supports efforts to identify savings and revenues outside of the Medicaid budget, such as increasing the tax on tobacco. Over the long term, we also must align incentives for providers and patients with best practices and appropriate utilization of services. Providers and patients alike must be held accountable for the long-term sustainability of this important safety net for low-income Mainers.

In the meantime, we strongly encourage the Legislature to address this problem thoughtfully and in a manner that protects low-income patients and the health services they need.

Bill Caron is president of Maine Health. Rich Peterson is president of Maine Medical Center.