Last month I chose to write my column about Medicaid expansion, the costs associated with it and some of the tough decisions that will have to be made to fund it. There has been some movement over the last few weeks on this issue, and I would like to take this opportunity to bring my constituents up to speed on what lies ahead.

When it comes to health insurance, the one point we can all agree on is that everyone should have it. But, as is the case with so many contentious issues, there are numerous opinions on how we achieve that goal.

We will likely be hearing a lot about this matter in the coming months in Augusta as legislators look for how best to fund Medicaid expansion, which Maine citizens passed on last November’s ballot.

It is important to recognize that Medicaid, which is known as MaineCare in our state, is a welfare program. It is government subsidized health care.

The term welfare is often used in a disparaging way, but it is important to note that Medicaid is a crucial service for our disabled and elderly citizens who cannot work and, without Medicaid, would be left without health insurance.

The expansion that was just approved by Maine voters is largely for childless adults who are capable of working. The federal government will pick up the tab for most of it, but Maine taxpayers will have to pay for a portion of it, and it won’t be cheap.

Figuring out how to pay for this is going to be an enormous challenge for my fellow legislators and me in the months to come.

As usual, there are limited resources available. Do we raise taxes in order to come up with the money for Medicaid expansion? After we fought so hard over the past few years to lower the tax burden on Mainers, this would be a very difficult choice for me.

Or do we cut funding for other government programs such as education? After we committed the largest one-time increase to K-12 education funding in state history last year, this is also an untenable choice. I would also be opposed to cutting programs that support our elderly, veterans, those with mental health problems or those with disabilities.

Budgetary concerns aside, there is one encouraging development regarding Medicaid.

This month, the Trump Administration gave states more flexibility in allowing them to impose work requirements for able-bodied Medicaid recipients. This is something that the State of Maine, under Republican leadership, has sought for some time.

If the recommendations are approved, it will mean that in order to receive Medicaid benefits, Mainers who are not disabled, elderly, pregnant or otherwise limited in their ability to work will have to be engaged in employment, searching for a job or doing some sort of community service.

I could not agree more with this approach. For some people, welfare has become a generational norm rather than a resource to help them stand on their own two feet.  

In many ways, work is a wonderful gift with mental and physical benefits in addition to the obvious economic benefits. It builds self-esteem and gives people meaning while they develop skills and make connections that result in higher pay and self-sufficiency.

As you can see, there is no easy or magic solution to this issue. I will continue to update you all of our progress as this session unfolds.

Senator David Woodsome is currently serving his second term in the Maine State Senate. He represents the people of Senate District 33 which consists of the towns of Cornish, Limerick, Newfield, Parsonsfield, Sanford, Shapleigh and Waterboro.