Maine regulators approve health plans under Obamacare, but impact remains unclear

By Jackie Farwell, BDN Staff
Posted July 31, 2013, at 7:24 p.m.

AUGUSTA, Maine — The state’s insurance bureau met a deadline Wednesday to report on how much some Maine consumers and businesses will pay for health coverage under the Affordable Care Act, often called Obamacare, but the impact of the new federal health law remains unclear.

The bureau released hundreds of pages of documents filed by two insurance carriers that plan to offer policies on Maine’s health insurance exchange, an online marketplace where consumers and small businesses will be able to shop this fall under the Affordable Care Act. Wednesday was the deadline for regulators in Maine and other states to approve insurance rates for the exchanges and report to the federal government.

In submitting the documents, the Maine Bureau of Insurance reported to the U.S. Department of Health and Human Services that the plans complied with health insurance regulations and appear to meet federal requirements to be sold on the exchange. The federal department will render the final decision.

The two carriers selling policies on Maine’s exchange are Anthem and the nonprofit Maine Community Health Options, which is new to Maine’s insurance marketplace. Consumers can begin enrolling in October, with the plans taking effect Jan. 1, 2014.

Maine’s submission to the feds was expected to shed light on how much consumers and small businesses will pay for insurance through the exchange and what benefits the plans will include. The trove of documents included a framework for how the insurers will set rates, but not a summary or side-by-side comparison of the plans, making it difficult to determine what consumers actually will pay, said Joe Ditre, executive director of the Augusta-based Consumers for Affordable Health Care.

“This gobbledegook is absolutely infuriating,” he said. “They’ve got to do a much better job of putting this into a format and form that the average consumer can understand.”

The documents detail how factors will raise or lower consumers’ premiums from a base amount — including their age, where they live and whether they smoke — but fail to include a needed breakdown of how much consumers can expect to pay for each product, he said.

“You’ve got to do all this complicated factoring in order to figure this out,” Ditre said. “That’s not the way to do it.”

Maine Bureau of Insurance spokesman Doug Dunbar clarified in an email late Wednesday that the agency plans to provide a summary by next week. The bureau’s staff worked diligently to complete its review within a short time frame after insurers filed to offer plans on the exchange to Wednesday’s federal deadline, he said.

Even when clear information about pricing becomes available, consumers will have to determine whether they’re eligible for federal subsidies that could lower their premiums, Ditre said.

Elsewhere in the country, regulators have used the release of exchange plan pricing as a political opportunity, declaring their support or disdain for Obamacare. Ohio, New York, California and other states have seen fierce public debate about their numbers, with liberal and conservative analysts heralding both dropping rates and skyrocketing prices based on the information.

Some states have produced side-by-side comparisons and issued press releases about whether health insurance rates were increasing or decreasing under Obamacare. But comparing health insurance plans is inherently difficult, as many consumers and employers are well aware — and was so even before the reform law’s up-ending of the health insurance market — given the variety in consumers’ circumstances and types of plans and benefits.

David Clough, Maine’s director for the National Federation of Independent Business, had a chance to scan the hundreds of pages of filings the state released on Wednesday.

“My eyes are going in circles and my head is kind of swimming,” he said.

More information will be necessary to make any conclusions, he said, but added that the filings are a start.

“The curtain on the future is being raised, and so now we’re beginning to see what 2014 will look like in the health insurance market,” he said. “There is so much that will be new that it will take some time to digest the information, and to compare choices and prices — the price will always be the ultimate decider of what people can afford.”

The exchanges, a key component of the federal Affordable Care Act, are targeted to individuals who lack insurance or buy their own policy, rather than through an employer, and small businesses. For the most part, people who have health insurance through their employer and those covered by public insurance such as Medicaid and Medicare won’t be shopping for insurance on the exchanges.

The state insurance bureau estimates that about 5 to 8 percent of Maine’s population will use the exchange.

Neither Anthem nor Maine Community Health Options released summaries of their products and pricing.

Kevin Lewis, CEO of the Lewiston-based Maine Community Health Options, said the nonprofit will publicize more information on its website by next week, after getting its first look at the insurance bureau’s release Wednesday.

“We’re very confident that we’ve come up with competitive pricing that will afford people new options in the marketplace,” Lewis said.

Maine Community Health Options will offer seven individual plans and five “small group” plans for small businesses, he said. The plans will offer a statewide network of health providers, including all of Maine’s hospitals, to treat consumers who buy the policies, he said.

The network proposed by Anthem already has been publicized, generating opposition from some western and southern Maine hospitals that were excluded. Last week, the insurance bureau largely approved Anthem ’s network, with conditions.

Anthem, which has partnered with MaineHealth, will offer 20 individual plans on the exchange, according to its filing. The company’s filing for small group plans remained under review Wednesday and was not released by the insurance bureau.

An Anthem spokesman said Wednesday that the company was still reviewing the bureau’s findings.

Joel Allumbaugh, an insurance broker and health policy expert at the conservative Maine Heritage Policy Center, said he hadn’t yet reviewed the filings, but conversations with insurance industry colleagues and regulators indicate individuals and small businesses can expect “substantially more expensive” health insurance under Obamacare.

He cited as factors the law’s prohibitions against high-deductible plans, which insurers have used to keep plans affordable, new requirements that insurers offer more comprehensive benefits, and taxes and fees under the law, among other contributors.

BDN Business Editor Whit Richardson contributed to this report.

http://bangordailynews.com/2013/07/31/health/maine-regulators-approve-health-plans-under-obamacare-but-impact-remains-unclear/ printed on July 26, 2014