Health insurance in Maine
- Maine uses the federally run health insurance marketplace at HealthCare.gov, although the state is planning to switch to its own exchange platform in the fall of 2021.
- Open enrollment period for 2021 medical coverage in Maine will run from November 1 – December 15, 2020. Residents with qualifying events can still enroll or make health insurance plan changes for 2020.
- In contrast to the LePage administration’s obstructionist approach, the Mills administration has actively worked to boost enrollment in private health insurance and MaineCare.
- Short-term health insurance plans can be sold in Maine with initial plan terms up to 12 months, but a new rule took effect in 2020 that prohibits short-term health insurance plans from extending past December 31 of the year in which they’re issued.
- Anthem rejoined Maine’s exchange for 2019; rate changes were very modest, thanks in part to new reinsurance program. For 2020, average premiums decreased slightly. Insurers have proposed another overall average rate decrease for 2021.
- Governor Janet Mills implemented Medicaid coverage expansion in Maine as soon as she took office in 2019, and her administration is promoting health insurance enrollment.
- Uninsured rate dropped from 11.2 percent in 2013 to 8 percent in 2018 (and has likely dropped even more since 2019, with Medicaid coverage expansion in effect).
- Maine’s CO-OP is one of just four still operational in the U.S.
- More than 25 percent of Maine’s population is enrolled in Medicare plans.
This page is dedicated to helping consumers quickly find health insurance resources in the state of Maine. Here, you’ll find information about the many types of health insurance coverage available. You can find the basics of the Maine health insurance marketplace and upcoming open enrollment period; a brief overview of Medicaid expansion in Maine; a quick look at short-term health insurance availability in the state; statistics about state-specific Medicare rules; as well as a collection of health insurance resources for Maine residents.
Maine’s health insurance marketplace
Maine uses the federally run health insurance marketplace, so residents in the state enroll via HealthCare.gov. But Maine plans to have a state-run exchange that uses the HealthCare.gov enrollment platform as of the fall of 2020, and a fully state-run exchange, with its own enrollment platform, as of the fall of 2021.
Anthem exited the Maine health insurance marketplace at the end of 2017, leaving just two insurers offering plans for 2018. But Anthem rejoined the exchange for 2019, so Maine is back to having three insurers offering plans in the exchange:
- Community Health Options
- Harvard Pilgrim HMOs
Average premiums in Maine’s individual health insurance marketplace increased by about 1 percent in 2019, decreased by about 1.6 percent in 2020, and are expected to decrease again in 2021. This rate stabilization (following sharp rate increases in 2017 and 2018) is due in large part to the reinsurance program that the state implemented as of 2019.
[But on the other hand, rates would likely have decreased in 2019 if not for the destabilizing actions of the federal government, including the elimination of the individual mandate penalty after the end of 2018, and the expansion of short-term and association health plans.]
In a departure from the LePage administration’s hands-off approach to health insurance outreach, the Mills administration actively worked to boost enrollment in Maine’s health insurance marketplace during the open enrollment period for 2020 coverage. The state launched a new website (coverME.gov) and a public outreach campaign designed to spread awareness of the state’s expanded Medicaid coverage as well as the private health insurance options available to individuals and small businesses.
Read more about the Maine health insurance marketplace.
Maine open enrollment period and dates
The open enrollment period for 2021 health plans will run from November 1 – December 15, 2021. Before that, residents with qualifying events can still enroll or make changes to their health insurance coverage for 2020.
Medicaid expansion in Maine
For the first five years that the ACA’s Medicaid coverage expansion was available, Maine was the only state in the northeast to reject federal funding for Medicaid expansion. But that changed in 2019, when Governor Janet Mills took office.
Maine voters approved Medicaid coverage expansion with a ballot initiative in 2017, but then-Governor Paul LePage blocked expansion throughout 2018. Mills, who had been serving as Maine’s Attorney General, had promised to make Medicaid expansion one of her first priorities upon taking office, and she signed an executive order to expand Medicaid coverage on her first day in office.
Read more about Medicaid coverage expansion in Maine.
Short-term health insurance in Maine
Maine tightened its short-term health insurance plan regulations as of January 2020, under a new law that was enacted in 2019. As of early 2020, there were no insurers selling short-term health insurance plans in Maine, due to the state’s strict regulations.
Short-term plans in Maine are no longer allowed to extend past December 31 of the year in which they’re issued, so the maximum duration (which was already limited to 12 months) will vary depending on the date that a plan is purchased. The new law includes additional restrictions, such as banning the sale of short-term health insurance plans during the open enrollment period for ACA-compliant plans (November 1 – December 15) if they’re scheduled to take effect in the new year.
Read more about short-term health insurance in Maine.
Maine and the Affordable Care Act
When Congress voted on the Affordable Care Act in 2010, Maine’s senators voted against the measures, while its two representatives voted for it. Sen. Olympia Snowe retired in 2013, and Sen. Angus King now represents Maine. King is generally supportive of the Affordable Care Act.
Sen. Susan Collins and Rep. Chellie Pingree remain in office. Rep. Michael Michaud, a Democrat, left office and was succeeded by Rep. Bruce Poliquin, a Republican, in 2015. Poliquin served as a Maine Representative until 2019, when Democrat Jared Golden took his seat after defeating him in the 2018 election. Golden wants to strengthen and build on the ACA, while Poliquin wanted to repeal the ACA and replace it with a “free market” solution.
In both 2011 and 2012, the Maine legislature considered bills to establish a state-run health insurance marketplace. However, the bills were not passed. Then-Gov. Paul LePage, a Republican, announced in late 2012 that Maine would default to the federally facilitated exchange.
LePage was firmly opposed to the ACA. In addition to opposing a state-run marketplace, he repeatedly vetoed legislation to expand Medicaid coverage, blocking it for the entire time he was in office. But residents of Maine approved a 2017 ballot measure to expand Medicaid, and although LePage blocked it throughout 2018, that was his last year in office and his successor, Governor Mills, implemented the will of the voters as soon as she took office.
How has Obamacare helped Maine?
Following the national trend, the uninsured rate in Maine dropped after the ACA’s individual mandate went into effect. According to U.S. Census data, the uninsured rate was 11.2 percent in 2013 in Maine, and 8.0 percent in 2018. It has likely dropped lower since then, with the implementation of Medicaid coverage expansion.
Maine’s CO-OP is one of just four still operational in the country
The Consumer Operated and Oriented Plan (CO-OP) Program was included in the Affordable Care Act to increase competition and consumer choice. Twenty-four CO-OPs, including Maine Community Health Options, received loans totaling $2.09 billion as of January 2014. Maine Community Health Options received about $64 million.
Since then, all but four Obamacare CO-OPs have closed. Maine’s CO-OP (Community Health Options) is one of the four that have remained operational. Community Health Options briefly offered plans in New Hampshire as well, but has since opted to focus solely on Maine.
For 2018, CHO increased their average premiums by 17.5 percent, but their average rate increase was less than 1 percent for 2019 and again for 2020. And for 2021, CHO has proposed an average rate decrease of more than 10 percent.
Medicare coverage and enrollment in Maine
As of May 2020, there were 344,108 Maine residents enrolled in Medicare plans. That’s more than 25 percent of the state’s total population. Nationwide, less than 19 percent of the population is enrolled in Medicare, but Maine has the highest average age in the country, so it’s not surprising that Maine has a larger population percentage of Medicare enrollment.
Learn more about Medicare enrollment in Maine, including the state’s rule for Medigap plans.
Health reform legislation in Maine
Scroll to the bottom of this page for a summary of recent state-level bills related to health reform.