Maine will launch a state-based health insurance marketplace at the beginning of next month, a process that will synthesize plan shopping for coverage under the Affordable Care Act.
The state has been working toward having its own marketplace for more than two years. A 2020 law that allowed the state to create its own marketing, outreach and enrollment programs was a main health care goal in the early part of Democratic Gov. Janet Mills’ first term.
Maine will join 15 other states — including all of New England except for New Hampshire — in using a state-based marketplace instead of the federal one after the administration of President Joe Biden approved the state’s plan on Monday. Here is what shoppers need to know.
What makes Maine’s marketplace different from the federal one?
Maine has been using a federal-local hybrid since last year’s enrollment period. The state handles marketing, outreach and customer service while the Healthcare.gov platform is used for applications and enrollment.
After Nov. 1, all of it will be centralized on Maine’s platform, called CoverME.gov. That means people will shop for, apply and get enrolled all in one location.
How will this affect health care shopping?
Nearly 60,000 Mainers got coverage through Affordable Care Act marketplaces ahead of 2021, with most individuals or families qualifying for subsidies. A special enrollment period from mid-February through July saw more than 9,100 new people enroll, more than double the number who did so last year.
State-run marketplaces can also create their own special enrollment period or extend enrollment periods without relying on the federal government, Woloson said.
“It’s more like one-stop shopping,” she said.
In addition to marketplace plans, people who are eligible for MaineCare, the state’s version of Medicaid, and its expanded version will have their applications sent directly to that office, rather than having to apply for it separately.
When do I enroll and who offers plans?
Shoppers will be able to see plan options on Oct. 15, with enrollment beginning on Nov. 1. They will have until Dec. 15 to get coverage that starts on Jan. 1, 2022, although open enrollment continues for another two weeks afterward.
Woloson said that bump was likely caused by two factors: people losing their jobs due to the pandemic and needing health insurance, and a federal subsidy provided by Congress through the American Rescue Plan Act making those plans more affordable. Those subsidies are slated to run out by the end of 2022, but a push is underway in Congress to make them permanent.
There is only one nonprofit health insurance co-op operating in Maine, Lewiston-based Community Health Options, one of three left in the country out of an original 23. Harvard Pilgrim and Anthem also offer marketplace plans and will do so in 2022.