January 20, 2020
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More Mainers sign up for health insurance as deadline nears

What could be more romantic than signing up for health insurance?

This year, the deadline to register for coverage under the Affordable Care Act coincides with Valentine’s Day weekend, so Maine health advocates tailored their pitches accordingly.

“Be a sweetie and enroll in health insurance!” organizers of a sign-up event at Calais Regional Hospital urged.

“Get insured on Valentine’s Day in Waterville!” another read.

The second sign-up season under the health reform law ends Feb. 15. Already, Maine has far surpassed last year’s enrollment total and landed at fourth in the nation for the percentage of eligible residents covered.

Between Nov. 15, 2014, when the open enrollment period began, and Feb. 11, 2015, the most recent date sign-up statistics were available, 66,118 Maine residents selected a plan or were automatically re-enrolled through HealthCare.gov, the federal health insurance marketplace, according to the U.S. Department of Health and Human Services.

That’s about 53 percent of the estimated 124,000 Maine residents eligible to buy a private insurance plan under the ACA. Only Vermont, D.C., and Florida boast higher proportions, according to ACASignUps.Net.

People who buy their own health insurance, rather than get coverage through work or the government, are eligible to shop at healthcare.gov.

With a couple of days remaining, Maine’s already on track to far exceed last year’s enrollment total of about 40,000 people.

“We’ve had a lot of people come in with last-minute questions and last-minute enrollments,” said Heather White, an outreach and enrollment specialist at Portland Community Health Center, who staffed a Friday sign-up event at the Portland Public Library. “The rush has been constant this week.”

Feb. 15 marks the last chance for most Americans to sign up for individual health plans that take effect this year. Only people with special circumstances — such as a marriage, adoption or job loss — can sign up after that date. The next open enrollment period isn’t until fall.

Erik Glockler of Augusta signed up for a plan in November after two years without health insurance. His job as a cook at a local restaurant didn’t offer coverage, so he paid out of pocket for medical bills he racked up because of a heart condition and his son’s health care, he said. Insurance was always too expensive, Glockler said.

“The cost was daunting, and I just really wasn’t sure what steps to take,” he said. “I felt kind of clueless.”

Glockler signed up for a plan with the help of Consumers for Affordable Health Care, a local advocacy group. The policy, which costs $120 per month, kicked in Jan. 1. Glockler’s no longer putting off doctor’s visits and other care he needs to manage his condition, he said.

“I’m starting to feel the rewards of having insurance,” he said.

Glockler is among the nearly 90 percent of Maine enrollees who qualified for a tax credit to offset the cost of their premiums. Those credits average $337 per person per month, according to federal health officials. With the financial leg up, nearly eight in 10 Mainers are spending $100 or less for a plan in 2015.

But the fate of the health law’s subsidies remains uncertain. By this summer, the U.S. Supreme Court will decide whether federal subsidies can be used only in states that established their own insurance marketplaces or, as is the case now, in states that use the federal marketplace.

More than half of all states, including Maine, use healthcare.gov. The case hangs on imprecise wording in the health reform law.

Health policy experts say consumers won’t be forced to repay subsidies because the court’s decision won’t be retroactive. But the financial help wouldn’t be available in 2016, making health insurance unaffordable for millions of people.

Maine Attorney General Janet Mills has urged the Supreme Court to uphold the subsidies.

While the health reform law offers the subsidies as a carrot to buy insurance, it also swings a stick. The majority of Americans who lacked health insurance in 2014 will pay a penalty at tax time. The penalty either amounts to 1 percent of annual household income or $95 per adult and $47.50 per child, whichever is higher.

For 2015, the penalty increases, either to 2 percent of annual household income or $325 per adult/$162.50 per child, whichever is higher.

Federal officials estimate 2 percent to 4 percent of taxpayers will get hit with the fine because they didn’t have health insurance last year. President Barack Obama’s administration is making a last-ditch enrollment push so more Americans meet the deadline this year.

Maine Insurance Superintendent Eric Cioppa reminded Mainers to enroll as the Feb. 15 deadline approached. Before buying a plan, consumers should check to make sure their doctors are included in the policy’s network, he said.

“I urge people to call both the insurance company and their health care provider to verify that the provider will be covered under the specific plan being considered,” Cioppa said in a news release. “Mainers should understand that a provider may be contracted by an insurance company under one plan, but not under another.”

Charges for medical services from a provider excluded from a plan’s network do not apply to the annual out-of-pocket maximum of $6,600 under the federal health law, he said. That could add up to significant extra cost for enrollees who use out-of-network providers.

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