Maine Community Health Options will no longer operate exclusively in Maine, as the health insurance co-op will begin offering plans on the New Hampshire health insurance marketplace starting in 2015.
The Lewiston-based co-op – a nonprofit owned by its members – will hire an additional 30 employees over two years, some in Lewiston, others in Concord and other locations in New Hampshire, said Kevin Lewis, its executive director.
The marketplace is where the previously uninsured – often self-employed or part-time workers – can purchase subsidized insurance through the Affordable Care Act. New Hampshire’s marketplace will jump from one insurer, Anthem Blue Cross Blue Shield, to five next year, with the Maine co-op in the mix.
Meanwhile, Maine’s marketplace in 2015 will include Anthem, Maine Community Health Options and new entrant Harvard Pilgrim Health Care.
With more insurance companies offering plans, New Hampshire residents will likely see lower rates. A 2014 study by the National Bureau of Economic Research found that residents who lived in states with one or few insurance companies operating generally paid higher rates.
Initially, the Maine co-op will offer plans in the four New Hampshire counties that border Maine – Rockingham, Strafford, Carroll and Coos – with plans in 2016 to expand into other New Hampshire counties.
After capturing 80 percent of Maine’s 44,000 health insurance marketplace enrollees, the Maine co-op has been praised nationally as a success story by industry experts and mentioned in the national media. Lewis met President Obama and Vice President Biden in April at a White House gathering of select co-op executives.
Lewis said the success in Maine was part of the reason the co-op was able to expand into New Hampshire.
“It’s given us a stronger position to work from,” Lewis said. “If we had had a lackluster performance (in Maine), we would not have been in a position to move forward.”
Emily Brostek, associate director of Consumers for Affordable Health Care, a health care advocacy group that helped people sign up for the health insurance marketplace, said the new co-op quickly gained a positive reputation among consumers.
“Because they were in Lewiston and did not have a national call center, I think they were easier to get ahold of if you had problems or questions,” Brostek said.
Also, being a Maine-based company probably spurred people to choose the co-op over Anthem, Brostek said, which in 2014 were the only two insurers offering plans in Maine. Without Maine Community Health Options, Mainers would have only been able to choose among Anthem plans.
Rates were similar between Anthem and the Maine co-op, according to Maine Bureau of Insurance filings. Anthem officials couldn’t be reached for comment Monday afternoon.
“I think consumers in Maine really welcomed having another player in Maine’s insurance market, and having a choice,” Brostek said.
Currently, New Hampshire residents do not have a choice in insurance companies – only Anthem offers plans.
The cooperatives were created as part of the Affordable Care Act to provide competition to traditional insurance companies, with federal loans to help them get off the ground. Maine’s co-op received a $65 million loan, but a co-op did not form in New Hampshire.
Another co-op, Minuteman Health of Massachusetts, is also moving into the New Hampshire market, along with traditional insurance companies Harvard Pilgrim and Assurant Health.
Meanwhile, cooperatives in Kentucky and Montana also are expanding operations to offer insurance in other states, according to Kaiser Health News.
“People were skeptical that the Affordable Care Act would work and that the co-ops would survive and thrive. But they have,” said Rep. Drew Gattine, D-Westbrook and a member of the Maine Legislature’s health and human services committee.
Lewis said the co-op is starting in the counties bordering Maine because the co-op already established a health care provider network in New Hampshire, so that Maine residents who live near the New Hampshire border can access health care in New Hampshire and still pay in-network costs. Out-of-network costs are typically more expensive.
He said the goal is for Maine Community Health Options to offer insurance in the marketplace to all New Hampshire residents in 2016.
“The New Hampshire market is fairly comparable to Maine, and we wanted to give the people in New Hampshire additional choices,” Lewis said.
More than 10 hospitals, including Concord Hospital, were excluded from the network in New Hampshire when Anthem established its provider network, according to news reports. With five companies offering plans in New Hampshire next year, that’s unlikely to be the case for 2015.
Joe Lawlor can be contacted at 791-6376 or at: