Health care has rightly held a dominant place in our national debate for many years now, and for good reason. It makes up a sixth of our national economy, and few policy areas touch us as personally as the debate over how to provide all Americans with quality, affordable health care.

Clearly, health care is an important local issue here in Knox and Waldo counties. The people in our community deserve access to good medical care at affordable costs, and there is no denying that our local health care organizations are major area employers and a key part of the local economy.

That’s why we all have a stake in Question 2 on this November’s ballot, which asks Maine people if they want to expand our state’s Medicaid program — known as MaineCare — to low-income people, most of whom have no other options for affordable coverage. 

There are good, compassionate reasons for doing this. If Question 2 passes, it would extend MaineCare coverage to nearly 80,000 low-income Maine people, many of whom work but have no access to affordable health insurance. This will translate into better health and medical outcomes for these individuals. Remember that these are our neighbors, our employees, our family and our friends. Though most have jobs, they do not earn enough income to qualify for subsidies on the Exchange. 

Question 2, however, is more than an opportunity to help hardworking Mainers. It is a chance to bring hundreds of millions of dollars to the state of Maine, create thousands of jobs and stabilize our community health networks, including Pen Bay Medical Center and Waldo County General Hospital.

With the federal government picking up no less than 90 percent of the cost of expansion, Maine will see an infusion of $496 million a year into its economy, and an estimated 6,000 jobs will be created as a result. While the state government will eventually have to pay 10 percent of the cost, this would amount to roughly a 5-percent increase in state Medicaid spending and account for less than 2 percent of the overall state budget.

This is good for Maine. Most of us with private insurance pay a lot more in out-of-pocket expenses than 10 percent of the cost. And indeed, if the state of Maine was asked to grant $55 million a year in tax breaks to attract an employer that would create 6,000 jobs and bring half a billion dollars 

a year into Maine’s economy, wouldn’t it make sense to do so?

Right here in Knox and Waldo counties, the Maine Center for Economic Policy estimates there will be a $39 million impact on our local economy, with 367 new jobs created.

Passage of Question 2 will also help to stabilize our community hospitals and local health systems. In fiscal 2016, 19 of Maine’s 34 hospitals lost money, and many others fell short of budget. In that year, Maine’s 36 hospitals had a combined operating margin of $29.4 million, but if you take Maine Medical Center and Eastern Maine Medical Center out of that mix, the remaining Maine hospitals lost $50.7 million. And while our hospitals are struggling to maintain services and meet their bottom lines, they are sending hundreds of millions of dollars to states that did expand Medicaid. Passage of the referendum would keep these dollars at home supporting our own Maine people in need.

Within our local organization, which includes both Pen Bay Medical Center and Waldo County General Hospital, Pen Bay was among those 19 hospitals that lost money, and we have worked hard against a difficult tide in recent years. Waldo County General, meanwhile, has fared better, as hospitals designated as “Critical Access” are eligible for more favorable reimbursement from the government. But the pressure on community hospitals is mounting. While expanding the MaineCare program won’t solve all the problems faced by our community hospitals, it will help to keep services in place.

As Mainers, we have to ask ourselves, what would be in the best interest of our most vulnerable residents and our communities?

The benefits of Medicaid expansion far exceed the costs. Voting “yes” on Question 2 is not just good for patients, our communities and our health care system, but also for Maine’s economy. That’s especially true for rural areas of our state like ours.

Mark Fourre, MD, President & CEO, Pen Bay Medical Center, Waldo County General Hospital, Coastal Healthcare Alliance