When I moved back to Maine in 2003 I was afraid of losing the Medicaid I’d fought so hard for in New York. So, before long, I found myself in the waiting room at the Maine Department of Health and Human Services office on Marginal Way. Again (oddly enough, since this is primarily a white state), in a room full of minorities, I was one of just a handful of white people. Again the décor was dingy and the wait was long and the office was understaffed. Again I had to bring my bank statements, my bills, my tax returns, and again I had to vouch for myself about why I needed care. Finally, a month or so later, I received clearance in the mail. I was overjoyed because the thought of going even a month without something covering me, and the care that is now routine in my life of ultrasounds and blood tests, terrified me.
But being on MaineCare is not without its challenges. Very few doctors actually take MaineCare. This past winter my doctor (who is a saint and does take MaineCare) found a cyst on one of my ovaries. I needed a gynecologist. I got recommendations and looked in the Yellow Pages and was repeatedly met with the same two responses: “We don’t take MaineCare patients,” or “We just stopped taking MaineCare patients.” Once, desperate, I suggested to a receptionist that she forget I’d just told her I had MaineCare and let me find a way to pay out-of-pocket the $200 fee. She told me no, that now that she knew I had MaineCare she couldn’t accept me as a patient. “Laws,” she said. (The state’s MaineCare rules bar doctors from accepting out-of-pocket payments from MaineCare recipients, unless they are either authorized co-payments or payments for services MaineCare does not cover.)
There have been doctors who have treated me shabbily, cursorily, as if my presence was not valuable in their schedule. Apparently they make anywhere from $23 to $70 on a MaineCare patient for a regular appointment, even if the doctor’s usual rate (as paid by commercial insurance plans or cash-paying walk-ins) is $250; even worse than the pay cut for the doctor is that the MaineCare computer system has been broken since 2005 and has not been reimbursing doctors quickly or accurately.
I found one doctor who acted as if anything extra I needed — extra time spent thinking about my conditions, extra time answering questions, extra time going through the different chemicals in the different birth-control pills — was a huge imposition on her busy practice. She just wanted to give me the oldest, cheapest pill that MaineCare covered. Even when I told her it didn’t matter, I’d pay out-of-pocket for the best pill for my body, she wouldn’t listen. I’ve often been relegated to the bottom of the pile since having Medicaid and treated as, and I know no better way to say it, a poor person. And poor in America means negligible. I don’t think of myself as poor, either. I’m educated, experienced, and, even more, I expect good care.
