In about three weeks, potentially tens of thousands of Maine residents will start shopping for health insurance on newly deployed, online insurance marketplaces, or exchanges, that will help consumers enroll in the plans they can afford and for which they qualify.
About a week before the Oct. 1 open date, the Maine Health Exchange Advisory Committee formed by the state Legislature will have its first meeting. The 16-member group plans to monitor how well the exchange formed under the federal Affordable Care Act is working for the Maine consumers and small businesses expected to use it to purchase insurance.
The group — with representation from the insurance industry, consumers, employers and the Legislature — will focus on a number of questions. Are federal subsidies making coverage affordable? Is needed coordination happening between Maine’s Medicaid program and the health insurance marketplace? Is the marketplace working for small businesses using it to insure their employees?
The state’s superintendent of insurance and Health and Human Services commissioner would do well to participate in such an effort. They run the two state agencies most closely involved in the work of insuring Maine residents. They should want to see the marketplace succeed. But per the policy of their boss, Gov. Paul LePage, Commissioner Mary Mayhew and Insurance Superintendent Eric Cioppa declined their invitations to join the advisory committee.
“Noting that we are not supportive of this particular measure, but also noting that the Bureau of Insurance is working to implement the exchange, we are not participating in that committee,” said LePage spokeswoman Adrienne Bennett.
LePage is also unhappy lawmakers used a special legislative order — rather than conventional legislation, which the unsupportive governor would have vetoed — to appoint the committee.
The insurance marketplaces are one of the key strategies used by the Affordable Care Act, or Obamacare, to cover some of the millions of people in the United States who lack health insurance. In Maine, the Bureau of Insurance expects 5-8 percent of the state’s population to use the marketplace to purchase insurance. The Congressional Budget Office expects about 85 percent of people who use the marketplace to buy insurance — which starts Jan. 1, 2014 — will qualify for subsidies that will cut the cost of monthly premiums.
But LePage wants no part of it, or at least as little to do with it as possible. Late last year, the Republican governor announced Maine wouldn’t run its own insurance marketplace. Instead, Maine — along with 26 other states — will use a marketplace operated by the federal government.
LePage also wanted nothing to do with the law’s other major initiative to grow insurance coverage: an expansion of Medicaid. In Maine, expanding the public insurance program would provide coverage for about 50,000 adults without children and prevent about 25,000 other low-income parents and childless adults from losing their Medicaid coverage on Jan. 1.
Even though Maine isn’t expanding Medicaid, the Kaiser Commission on Medicaid and the Uninsured estimates Maine’s Medicaid program will still add 10,000 enrollees. That’s because as the Affordable Care Act’s individual mandate takes effect, people will explore their insurance options, and many will realize they’re eligible for Medicaid though they hadn’t previously signed up.
The Maine Bureau of Insurance undertook significant work to make sure the private insurance plans offered to Maine residents through the health insurance marketplace met federal requirements. The bureau is holding information sessions across the state to make residents aware of coverage options through the exchange.
The Maine Department of Health and Human Services is making sure its Medicaid computer systems communicate with the health insurance marketplace.
But the LePage administration’s choices against expanding Medicaid, against having Maine operate its own health insurance marketplace and against having administration officials participate in the health exchange advisory committee fit into a broader trend of Republicans across the country — intent on seeing a signature initiative of Democratic President Barack Obama’s fail — undermining the ability of Obamacare to reach its 100 percent insurance coverage goal.
But to what end, other than a bizarre attempt to claim political victory from throwing up obstacles in the way of the uninsured gaining coverage?
The LePage administration might not support Obamacare, but it’s the law. The administration should do everything in its power to make sure the law works, and works well, for Maine residents.
The end result will be more residents with insurance coverage that allows them access to care without going bankrupt.