November 16, 2012

Obamacare delay may not help Maine

Even with the deadline extended through Dec. 14, the outgoing Republican majority may have waited too long for Maine to set up a locally controlled, Maine-specific healthcare exchange.

By Steve Mistler
Staff Writer

The Obama administration announced Thursday evening that it will extend by a month the deadline for states to tell the government how they will implement a key component of the president’s health care law. The deadline had been Friday.

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Gov. Paul LePage, center, sent a letter to Health and Human Services Secretary Kathleen Sebelius saying the state would not create a state-run exchange because the health reform law “is a stepping stone to a single-payer system."

Andy Molloy / Staff Photographer

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Read Gov. Paul LePage's letter to HHS Secy. Kathleen Sebelius

But even with the extension to Dec. 14, it may be too late for Maine to decide to build its own online insurance market for individuals and small businesses to shop for private coverage.

Over the past two years, the outgoing Republican majority in Maine’s Legislature stalled the planning process for the state to build its own exchange.

Maine is one of 16 states that have yet to notify the Obama administration whether they planned to create a health insurance exchange mandated by Obamacare, also known as the Affordable Care Act.

The federal government will take over for states that miss the deadline to ensure that the exchanges are up and running by January 2014. States can also opt to run a partnership exchange, in which they would split responsibilities with federal officials. To go that route, states must notify the federal government by mid-February, according to the Washington Post.

The decision to extend the deadline came in response to a Wednesday letter from Virginia Gov. Robert F. McDonnell and Louisiana Gov. Bobby Jindal, signed by LePage and other governors, asking President Obama to push back the impending deadline, the Washington Post reported.

The two governors made the request on behalf of the Republican Governors Association; both have said their states will not set up an exchange.

In a letter addressed to McDonnell and Jindal, Health and Human Services Secretary Kathleen Sebelius wrote, “We’re confident Governors will have enough time to decide whether they want to establish an Exchange, work in partnership with the federal government or have a federally-facilitated Exchange in their state.”

Before the deadline was extended, Maine and the 16 other states appeared to have decided to let the feds set up their exchanges.

Gov. Paul LePage sent a letter to the Obama Administration Thursday saying Maine “is not going to assist in the implementation of this (law) in its current form.”

Legislators from both parties, on the other hand, said it is still in the state’s interest to have a role. Democrats said they hope to work with federal officials to design the exchange.

Few in Maine state government welcome federal intervention, a scenario precipitated by Republican resistance to the law and their gamble that it would fail in court or be repealed in Congress.

Concerns about a federally-established exchange center on a lack of local control and a one-size-fits-all Web marketplace that may not work effectively, particularly in rural Maine where high-speed Internet access is limited. Some also worry that a federally-established exchange would include insurance plans that don’t fit the coverage needs of Maine’s population.

The exchange also will allow individuals to find out whether they qualify for federal subsidies or Medicaid, taxpayer-funded health insurance for low-income people.

Nonetheless, a federally-run exchange looms in Maine, at least in the short-term.

“The Republican Legislature basically stuck its head in the sand and hoped the health care law would go away,” said Rep. Sharon Treat, D-Hallowell, the ranking Democrat on the Legislature’s Insurance and Finance Committee, before the deadline extension had been announced.

“We had plenty of chances to create our own exchange and manage it, but we wasted two years doing nothing. Now it’s too late.”

On Wednesday, Gov. LePage signed the letter along with 20 other Republican governors that was sent to the Obama administration requesting more time and guidance.

On Thursday, however, LePage sent a letter to Health and Human Services Secretary Kathleen Sebelius saying the state would not create a state-run exchange and saying the health reform law “is a stepping stone to a single-payer system. Maine will not be complicit in the degradation of our nation’s premier health care system.”

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