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

(Continued from page 1)

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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

Democrats, meanwhile, will take over majority control of the Legislature in January and said they hope a federally-run exchange is temporary.

It’s unclear whether the federal government will support or help subsidize future efforts to create a Maine-based exchange. It did two years ago, promising the state over $6 million to help plan and implement its own marketplace by picking insurers, health plans, staffing levels and an oversight board.

Maine was well on its way to implementing Obamacare in the summer of 2010. But the 2010 election put LePage in the governor’s office, Republicans in control of the Legislature and effectively changed the state’s path from implementation to resistance.

The administration immediately dissolved the bipartisan planning commission for the law. Shortly thereafter, newly-elected Republican Attorney General William Schneider entered Maine into the multi-state lawsuit challenging the constitutionality of the health care law’s lynchpin provision, the individual mandate.

State officials awaited a U.S. Supreme Court decision on the lawsuit.

Nonetheless, planning for the law’s implementation continued, albeit slowly, in case the law was upheld.

In 2011, LePage created an advisory committee comprised of insurers and hospitals to explore how to create the exchange. The committee unanimously recommended that the state create its own.

“The biggest concern is that you lose control over the exchange,” Joe Bruno, a former Republican lawmaker who became chairman of the advisory committee, said Thursday. “With a federally-run exchange you don’t know what plans are going to be in it. You could end up with something cookie-cutter that just doesn’t fit here.”

The advisory committee’s recommendation was supposed to become legislation to green-light the exchange. But as the U.S. Supreme Court decision on the law approached, Republican lawmakers balked. The state spent $1 million on planning the exchange, but turned down another $5.8 million in federal money to move forward and implement it.

Sen. Rodney Whittemore, R-Somerset, told the Press Herald in March, “Seeing how the state of Maine is opposed to Obamacare, we felt it was a bit hypocritical to move forward with an exchange at this time.”

Business leaders, including the Maine State Chamber of Commerce, called the decision a missed opportunity. Republicans countered that they saw no need to spend money implementing a law that could be struck down.

When the U.S. Supreme Court ruled the law constitutional, Republicans in Maine and many other states still declined to make a decision. Hopes shifted from the court to presidential hopeful Mitt Romney, who vowed to repeal Obamacare if elected.

Rep. Kenneth Fredette, R-Newport, the incoming House minority leader, said that a federally-run exchange is not in the state’s best interest, but that it did not make sense for lawmakers to revisit the exchange issue after the court ruling. Moving forward, however, he said it is important that Maine have a say.

Democratic lawmakers have submitted legislation that would give the state some say about the design of a federal exchange, but it’s unclear how or when it will take effect, or whether LePage will support such a bill.

Treat, the Democratic lawmaker, said she’s hopeful the federal government and the state can at least work together to create an exchange that works here.

“Nobody wants to wait for Jan. 1, 2014, to come around and discover people can’t buy health insurance,” Treat said.

Staff Writer Steve Mistler can be contacted at 791-6345 or at:

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