June 18, 2018
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Maine’s Obamacare advisory committee leaves Medicaid expansion off its first list of recommendations

By Christopher Cousins, BDN Staff

AUGUSTA, Maine — Steering more people toward health insurance coverage in one way or another was at the core of recommendations completed Monday by a committee tasked with overseeing the implementation of the federal Affordable Care Act in Maine.

Among the Maine Health Exchange Advisory Committee’s unanimous recommendations were applying for federal funds to help individuals and small businesses sign up for health care coverage and exploring the possibility of implementing a state-level health care exchange in 2016 if problems with the beleaguered federal exchange continue.

Because the bipartisan, volunteer committee sought consensus agreement in its report, which is due to the Legislature and executive branch on Dec. 15, the recommendations sidestep an outright call for the expansion of Medicaid in Maine. The issue has been under debate since Congress and President Barack Obama enacted Obamacare, with the dividing line falling between those who want health care to be available to everyone and others who say the prospect is too expensive and will crowd out other important state programs.

Instead of advocating for the Medicaid expansion explicitly, the committee adopted language that calls for measures that will help close the “coverage gap,” which refers to people who earn too much money to qualify for Medicaid and not enough to afford a private insurance policy, even with subsidies from the federal government under the Affordable Care Act.

“The advisory committee supports access to health coverage and the goal of reducing the uninsured and would support policy changes that would close the coverage gap and expand access to health coverage,” reads a draft of the committee’s report.

Rep. Michael McClellan, R-Raymond, was one of the leading voices on the committee against Medicaid expansion, though he said in a prepared statement Monday that he is open to other methods of providing health insurance to more Mainers.

“The one thing we all agreed on was that the more people who have coverage, the better,” he said. “Medicaid expansion under Obamacare, however, would be the biggest fiscal mistake in Maine’s history.”

Among the other recommendations were the following:

— Encourage the state to apply for federal grants that are available under the Affordable Care Act to help educate Maine residents about their health insurance options and sign them up for coverage. The committee recommends using this money to hire more “navigators,” who help people use the sign-up website, www.healthcare.gov, cover ACA-related costs for the Bureau of Insurance and target resources toward small businesses.

— Pursue changes in state and federal law that will create more transparency around impending changes to composite ratings by health insurers. A composite rating is a formula used by health insurers that averages all of the risks in an insurance plan in order to set individual premiums. The committee said the changes in law will provide more long-term financial certainty to employers and small businesses planning their health plan costs.

— Maintain the federally facilitated marketplace through 2015 and consider a change to another system in 2016 if the marketplace doesn’t adequately serve individuals and businesses.

— Ensure that all notices and written communications distributed by the Maine Department of Health and Human Services are “useful to consumers and accurately reflect the health care coverage options available.” This recommendation comes amid queries by the committee about anecdotal reports that DHHS is inaccurately telling MaineCare recipients who are losing their coverage that their information is being forwarded to the federal marketplace and that they will be contacted by the federal government. As of the committee’s meeting Monday, information requests from the committee on this matter have not been answered by DHHS, which angered Rep. Sharon Treat, D-Hallowell, chairwoman of the committee.

“Can we sent a [Freedom of Access Act] request?” asked Treat, who wants copies of the notices that have been sent to consumers. “I think we have a right to see what a state agency is sending out to Maine citizens. I don’t like the idea that we’re writing a report based on hearsay.”

The committee also seeks to develop processes to better track demographic, eligibility and enrollment data from the Department of Health and Human Services and the Bureau of Insurance.

The committee plans to monitor these issues throughout 2014.

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