By Carla Anderson
April 21, 2014
The open enrollment period to purchase health insurance for 2014 through the marketplace has ended. People who get married or divorced, change jobs, have a child or experience another qualifying event may be eligible for a special enrollment period. Enrollment for Medicaid and the Children’s Health Insurance Program (CHIP) continues throughout the year. You may be able to buy private insurance outside the marketplace. Individuals who don’t have health insurance that provides “minimum essential coverage” may have to pay a penalty: $95 or one percent of income, whichever is greater.
Open enrollment for 2015 coverage through the marketplace begins Nov. 15.
More than 25,000 Maine residents enrolled in private health plans between Oct. 1 and March 1. Maine is ahead of the federal government’s target for signups through five months of the initial open enrollment period. In addition to health plan enrollments, about 5,500 people qualified for Medicaid or the Children’s Health Insurance Program (CHIP). Ninety percent of those selecting a health plan qualified for subsidies to help pay the cost of their premiums, compared to 83 percent nationally. The percentage of 18 to 34 year-olds signing up in Maine was among the lowest in the nation — just 19 percent compared to 25 percent nationally. Signups among that age group are considered vital to keeping insurance costs from jumping up in 2015 and beyond. Given the high average age in the state, a lower percentage of younger enrollees is not surprising.
Maine’s health insurance marketplace is operated by the federal government. Gov. Paul LePage announced the state’s decision against a state-run model in November 2012. In a letter to U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, LePage said the Affordable Care Act has “severe legal problems” and state-run exchanges will be “actually controlled” by the federal government. LePage’s administration did explore creating a state-run exchange. The governor appointed an advisory committee, and in September 2011 that committee recommended that Maine implement a state-run exchange. The committee also issued recommendations as to how the exchange should be structured and governed. However, Maine ultimately joined the Supreme Court case that attempted to overturn the Affordable Care Act, and the state legislature failed to pass exchange legislation in both 2011 and 2012.
Democrats in the Maine Legislature pushed for Medicaid expansion during the 2014 session. One bill included a provision to end Maine’s participation by 2017 when states must begin paying a small percentage of expansion’s costs and another provision that allowed the state to end the expansion if the federal government failed to follow through on the pledge to pay 100 percent of program costs for three years. However, Gov. LePage vetoed the bill. Another bill, passed on the last day of the regular session, would expand Medicaid for one year while seeking approval to pursue a “private option,” whereby federal funds would be used to help residents buy private health insurance through the marketplace in future years. About 70,000 people could gain health insurance coverage through the expansion.
State Exchange Profile: Maine
The Henry J. Kaiser Family Foundation overview of Maine’s progress toward creating a state health insurance exchange.
Let your Maine governor and legislators know how you feel about the state’s proposed health insurance exchange.Maine Governor Paul LePage