April 25, 2018
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Maine businesses caught in middle of health reform

By Meg Haskell, BDN Staff

AUGUSTA, Maine — Maine businesses are caught between a rock and a hard place these days, trying to prepare for the complex and evolving demands of national health reform while still responding to the immediate crisis in Maine’s health insurance market.

Challenges to constitutionality of the new federal law, along with the passage earlier this year of sweeping changes to health insurance regulation in Maine, further complicate the decisions businesses must make.

On Wednesday, representatives of several dozen Maine businesses attended “Federal Health Reform: One Year Later,” a half-day conference at the Augusta Civic Center organized by the Maine State Chamber of Commerce. The event aimed to explain the status of the federal reform and help participants anticipate the changes ahead. It also provided some speakers with an opportunity to take shots at the national reform law.

While the currents of health reform continue to swirl, Maine businesses should not get bogged down in trying to second-guess the final outcome, said presenter Joel Allumbaugh of the conservative Maine Heritage Policy Center. Allumbaugh, an insurance underwriter by profession, said he views the political scrambling and posturing of the past year since the passage of the Patient Protection and Affordability Act as a sort of “pause” in the national momentum toward meaningful reform.

Businesses, he said, should be taking steps to comply with the law as it is written.

“To plow forward thinking it’s not going to take effect would be a mistake,” he said.

Katie Hays, executive director of congressional and public affairs for the U.S. Chamber of Commerce, told the conference attendees that they must stay engaged and informed as the convoluted reform process goes forward.

The U.S. Chamber of Commerce opposed the passage of the Affordable Care Act in 2010 and supports efforts to overturn the employer mandate that requires employers to either provide coverage or pay a penalty. Despite the possibility of repeal, “the [Affordable Care Act] is the law of the land and we must be preparing ourselves,” Hays said.

She took the opportunity to tell her largely politically conservative audience that the federal law calls for $569 billion in new taxes, will create 16,000 new jobs within the Internal Revenue Service and depends on cuts in the popular Medicare program to find savings in the health care system.

She cautioned that states must be active in setting up their insurance exchange marketplaces, where consumers can shop for affordable coverage as required by the federal reform.

“If states don’t have a plan in place by 2013, the federal government will come in and set something up in your state,” she said.

More than half of Americans surveyed disapprove of the new law, Hays said, although disapproval has waned because of the phased-in timeline. And a recent survey of employers indicated that many would consider paying a penalty and discontinuing insurance coverage for workers once the insurance exchange marketplaces are in place.

Speaking for Anthem Blue Cross and Blue Shield of Maine, the state’s largest health insurer, Christine Ossenfort tried to explain the high points of Maine’s new health insurance reform law. Before accepting her current position with Anthem, Ossenfort worked as a lobbyist for the Maine State Chamber of Commerce.

Maine’s regulatory environment has been far more restrictive than most states’ she said, and the new law seeks to rectify that. The state reform brings Maine’s rate-setting regulations in line with the goals of federal reform, establishes a reinsurance pool to help pay for policyholders who use a lot of health care services and promotes competition among insurance companies, Ossenfort said.

Attorney Philip Saucier, who served as a policy adviser for former Gov. John Baldacci, stepped away from the politics of health care reform to clarify the court challenges to its constitutionality.

The reform law has survived four challenges in courts presided over by judges appointed by former President Bill Clinton and has been found unconstitutional by judges in Virginia and Florida who were appointed by former President George W. Bush, he said.

“It really is becoming a partisan issue, even though the courts are not supposed to be political,” he said. Although the ACA is headed for a showdown in the U.S. Supreme Court, he said, it is more likely that certain provisions will be overturned rather than the entire law.

Certain provisions have already taken effect, he said, including tax breaks for small businesses, a measure that allows young adults to stay on their parents’ health insurance plan, and the gradual closing of the unpopular coverage gap in Medicare’s prescription drug plan.

“It would be hard to unwind the clock,” Saucier said.

Among those attending the conference were Richard Giguere, president of the Ware-Butler building supply business in Waterville, and his office manager Melissa Jacques.

“Everything is still so up in the air,” Giguere said during a break in the agenda. Like many Maine employers, Giguere is struggling to continue providing health insurance to his approximately 30 full-time employees. Each year, the cost goes up and he is forced to raise the deductible, reduce the benefits, or increase employees’ share of the monthly premium — or some combination of the three.

At the same time, the company must prepare for coming changes, regardless of the many uncertainties of the state and national laws, said Jacques.

“But it’s hard to keep up with it all, because it’s constantly changing,” she said. Wednesday’s conference served as more of a policy review than a hands-on workshop for companies like Ware-Butler, she said, that don’t have the resources to dedicate to interpreting the finer points of the reforms.

More information about complying with state and federal health insurance reforms is available on the website of the Maine State Chamber of Commerce as well as from the nonprofit organization Consumers for Affordable Health Care.

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