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Maine health insurance exchange

maine guide to health insurance

Maine reaches 138 percent of marketplace enrollment goal

By
March 31, 2014

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.

March 31 is the last day to apply for private health insurance coverage for 2014. However, federal fficials announced that anyone who has started an application on HealthCare.gov but not completed it as of March 31 can have until April 15 to finish enrolling. The extension is available in Maine and all other states using HealthCare.gov for enrollment. Consumers can qualify for the extension just by clicking a box on HealthCare.gov; no documentation is needed.

Enrollment for Medicaid or CHIP continues throughout the year.

Individuals who remain uninsured after March may face a tax penalty of $95 or one percent of income, whichever is greater.

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.

In late March, the Maine Legislature passed a bill supporting Medicaid expansion.Senate Democrats included a number of provisions in the current bill in hopes of attracting Republican votes. One provision ends Maine’s participation by 2017 when states must begin paying a small percentage of expansion’s costs. Another provision is an opt-out clause that allows the state to cancel the expansion if the federal government does not follow through on the pledge to pay 100 percent of program costs for three years. Democrats are also warning of the damage to Maine’s economy, saying the state misses out on about $1 million a day by not expanding Medicaid. About 70,000 people could gain health insurance coverage through the expansion.  Gov. LePage has vetoed two previous expansion bills.

Just two insurers are offering policies through the marketplace in Maine: Anthem Blue Cross and Blue Shield and Maine Community Health Options (MCHO). Nationally, the average is eight insurers per state.

According to a report released by HHS, the average cost for a bronze plan —the lowest-cost option — in Maine is $328 a month. That’s much higher than the national average of $249 a month for a bronze policy. Health insurance has traditionally been expensive in Maine due to the state’s rural nature, high average age, and few insurers. While the marketplace may ultimately trigger more competition, the other underlying cost drivers will remain.

According to HHS, about 145,000 Maine residents (13 percent of the state population) are uninsured and eligible to use the marketplace.

Maine health insurance exchange links

HealthCare.gov
800-318-2596

Enroll207

State Exchange Profile: Maine
The Henry J. Kaiser Family Foundation overview of Maine’s progress toward creating a state health insurance exchange.

Maine Quality Forum

 Maine Bureau of Insurance – Federal Health Care Reform

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Maine Governor Paul LePage
#1 State House Station
Augusta, ME 04333-0001
PHONE: 207-287-3531
FAX: 207-287-1034
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