Just over three months ago President Obama signed the Affordable Care Act of 2010 into law. For the countless individuals and small businesses struggling to access quality, affordable health care, the moment was years in the making.
Many aspects of the law will take effect this year, including ending some of the insurance companies’ worst practices, creating tax credits for small businesses, expanding coverage for young adults and closing the doughnut hole and improving preventive care for seniors. Other provisions of the law to expand on these first steps will be phased into effect over the next several years, such as health insurance exchanges that will allow individuals and small businesses to pool together and use their collective leverage to get better deals and more accountability from insurance companies.
The federal law offers state governments, private businesses, nonprofits and individuals options to assist in reducing their costs for health insurance and health care delivery. As a member of the Legislature’s Joint Select Committee on Health Care Reform Opportunities and Implementation, I am working with 16 other legislators from both parties to take a thorough review of the law and determine what areas Maine needs to be prepared to take action on to ensure our businesses and individuals can maximize its benefits.
Because of the passage of federal health care reform, many of the practices that insurance companies employed to maximize profits by denying legitimate claims and coverage will be ended. No longer can you be dropped or denied health care because of a pre-existing condition. Lifetime caps and annual limits on insurance claims are eliminated.
One item that I am particularly enthusiastic about is the provision to ensure that young adults, people like me, can access health insurance through their parents’ plans. People between the ages of 18 and 26 are one of the largest segments of the uninsured in America. Many are just starting out their careers and are in entry level positions that don’t offer benefits, or they can’t afford to purchase coverage if it is offered.
Another aspect of the law that I am excited to learn more about is the health insurance exchanges. There are lots of folks that aren’t happy with their insurance coverage and want to change it. That is where the exchanges will come into play. I will be working to make sure that Maine’s version of the exchange provides a way for small businesses and individuals to leverage their collective power against large insurance companies.
When you shop the individual market you are a tiny fish in a big sea and you are at the mercy of insurance companies. In Maine and across the country, large, greedy insurance companies such as Anthem have recently raised rates in these markets by as much as 48 percent a year.
This hits Maine particularly hard when you consider that in 2006, according to the U.S. Census, 93 percent of Maine’s businesses had fewer than 50 employees. It isn’t surprising then that in 2008 in Maine, only 45 percent of businesses with fewer than 50 employees offered health insurance, according to the Kaiser Family Foundation.
The idea behind the exchanges is that individuals and small business, those with fewer than 100 full-time employees, will be able to pool their resources to increase their buying power in the insurance marketplace. As insurance carriers compete for your business they will be keenly aware that you now have other options. Now you, the tiny fish, have more power, more options and the playing field will be tipped toward your favor.
The federal law requires that states develop their exchange by 2014 and some of the guidance is still going through rule-making. I am hopeful that as these regulations are completed Maine can explore the possibility of getting our individual and small-business exchange operating sooner.
As anyone who watched the process unfold in Congress knows, the new law has a lot of components. With health care now accounting for nearly 15 percent of America’s gross domestic product, decisions affecting health care are moral decisions that show how we take care of each other. As Maine works to implement these historic reforms, I am hopeful we will continue on our path to expand access to affordable, quality health care.
Rep. Adam Goode, a Democrat, represents part of Bangor in the Maine House of Representatives.