A demonstrator holds a sign in front of the U.S. Supreme Court as arguments are heard about the Affordable Care Act, Tuesday, Nov. 10, 2020, in Washington. Credit: Alex Brandon / AP

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David L. Levy of Orono is a retired nephrologist.

The Affordable Care Act was one of the most significant pieces of legislation passed by the Obama administration. The goal of this law was to make affordable, quality health care accessible to more Americans. The ACA is certainly an imperfect law due to the numerous compromises necessary for its passage, but it did result in approximately 20 million additional Americans having health insurance. The hope was that this would be a first step toward achieving universal access to health care.

I practiced medicine in Maine for 38 years and saw many patients suffer as a result of an inadequately funded and fragmented system of health care. In my specialty of nephrology, people often presented with advanced kidney disease because they had been unable to access care when their disease was at a more manageable stage.

High blood pressure is very treatable, but if it is not controlled, it can lead to severe kidney failure. It is devastating when patients first learn of their kidney disease when they are already at the point of requiring dialysis. Adding insult to injury, appropriate medications for managing their chronic kidney disease are often unaffordable.

Since the ACA was passed, it has been the stated goal of Republicans to achieve its repeal. Donald Trump campaigned on a platform that included repeal of Obamacare and replacing it with something much better. While no proposal for a replacement program was ever put forward, enormous energy was directed toward repeal of the ACA.

Republicans never succeeded in completely overturning the ACA, but many important provisions were discontinued. Among these was the health insurance assessment, which was a fee that insurance companies paid in return for the privilege of selling policies on the marketplace created by the ACA. The discontinuation of this provision by the Trump administration results in an annual loss of approximately $15 billion per year for the U.S. government.

A bill currently being considered by the Maine legislature would bring back the health insurance assessment on the state level. LD 1463, An Act to Make Healthcare Coverage More Affordable for Working Families and Small Businesses, would require health insurance companies ( currently reaping record profits) to pay this fee to the state of Maine. This would provide approximately $30 million in yearly state revenue directed to a fund dedicated to mitigating out-of-pocket healthcare costs and helping to cover skyrocketing prescription drug expenses for Maine citizens.

I urge the state Legislature to pass this bill to help ensure that Mainers have access to affordable quality health care.