EDITORIAL

Maine needs to get moving on a health insurance exchange

Posted July 04, 2012, at 4:39 p.m.

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President Barack Obama shakes hands after speaking about health care reform at the Portland Expo Center, in Portland in April 2010.
Alex Brandon | AP
President Barack Obama shakes hands after speaking about health care reform at the Portland Expo Center, in Portland in April 2010.

If you are uninsured, or you’re a business owner wanting to compare health insurance plans, in the future you might rely on a health insurance exchange. The online exchange is where you’ll be able to see what private health plans are most suitable for you, find out whether you’re eligible for tax credits and, finally, enroll in a plan.

Simple, right?

But Maine doesn’t yet have an exchange, and it doesn’t appear to have a strategy for building one, even though President Barack Obama’s Affordable Care Act has been ruled constitutional. If the state doesn’t set one up soon, or partner with the federal government to build one, the federal government will do it for Maine.

And it appears more and more likely that the federal government will take the lead. Gov. Paul LePage said recently he will wait to make a decision on the exchange until after he gets answers to implementation questions and until after the November elections, which would be near to the deadline to create one. That’s unfortunate because it makes the most sense for the state to have a say in developing the exchange. We would rather see LePage direct state legislators to return for a special session as soon as possible to approve one.

Maine knows better than the federal government how to reach out to Mainers and educate them about an exchange. Maine knows better the needs of its small businesses. Maine should be the one to choose which plans are offered through the exchange and what the required benefits are. If there isn’t enough time for Maine to help develop a well-thought-out exchange now, it would be good for LePage to announce that he would like to create a state-based one in the coming years.

It would be understandably difficult for some legislators now to work on an exchange when they opposed the health care law. But the benefit to Mainers should come before pride or ideology. If the federal government is going to require an exchange, it’s only to Maine’s advantage to have a hand in it.

And deadlines are fast approaching. The state must submit a declaration letter signed by LePage and an application to the secretary of the U.S. Department of Health and Human Services by Nov. 16. It then has until Jan. 1, 2013, to develop more exchange components to show it will be able to enroll people by Oct. 1, 2013, and operate by Jan. 1, 2014.

People who oppose the health care law say that devising an exchange is too expensive and time consuming. Setting one up would be complicated — and the exchange will have to establish a funding stream to be self-sustaining — but the end results, to clarify the best health insurance plans and streamline the sign-up process, are important. And there is financial assistance. Maine has already won millions of dollars in federal grant money to design the exchange, and the health and human services secretary said recently she will open up additional financing sources.

Maine is one of only three states that has decided not to create a state exchange, according to the Kaiser Family Foundation. The others are Louisiana and New Hampshire. So far 15 states have established state exchanges; one is planning for a partnership exchange; 18 are studying their options; and 14 have no significant activity.

Maine Republicans already put off the exchange in hopes that the Affordable Care Act would be overturned. In March a bill — LD 1498 — that would have set up Maine’s exchange failed in the Legislature’s Insurance and Financial Services Committee in a party-line vote. Republicans who hope that the results of the November elections will propel the law’s repeal are again relying on wishful thinking. That’s no way to represent constituents. Legislators should help make the law work for Maine people.

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