Maine health insurance exchange
Maine health insurance exchange
By Carla Anderson
July 24, 2014
Open enrollment in Obamacare has ended in Maine for coverage this year. 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. 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 44,250 Maine residents enrolled in qualified health plans (QHPs) during the 2014 open enrollment period. Enrollment jumped 74 percent in the final weeks, having reached 25,412 as of March 1. In addition to QHP enrollment, 7,103 people qualified for Medicaid or the Children’s Health Insurance Program (CHIP). Ninety percent of those selecting a QHP qualified for subsidies to help pay the cost of their premiums, compared to 85 percent nationally. Nineteen percent of Maine residents selected a bronze plan (20 percent nationally), 72 percent selected a silver plan (65 percent nationally), 8 percent selected a gold plan (9 percent nationally), 0 percent selected a platinum plan (5 percent nationally) and 1 percent selected a catastrophic plan (2 percent nationally). Twenty-two percent of Maine enrollees were between the ages of 18 and 34.
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.
Maine health insurance exchange links
State Exchange Profile: Maine
The Henry J. Kaiser Family Foundation overview of Maine’s progress toward creating a state health insurance exchange.