January 23, 2013

Details still uncertain about Maine health exchange

State seeks information on costs, consumer protection and state oversight for next year.

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

AUGUSTA – Maine legislators still have questions about the state's planned involvement in a new federal health insurance exchange under the Affordable Care Act.

The Legislature's Insurance and Financial Services Committee is seeking information on costs, consumer protection issues and state oversight as Maine prepares to use the online federal exchange starting in January 2014.

The committee also heard new information Tuesday about the possibility of establishing a federal-state partnership exchange, which would allow the state to manage health insurance plans and provide consumer assistance.

The Obama administration gave states the option of establishing a federal-state partnership exchange in July 2011, but the insurance committee never considered it, said Rep. Sharon Treat, D-Hallowell, co-chairwoman and longtime committee member.

Still, Treat said she wouldn't support switching to a partnership or state exchange without gathering much more information, rallying bipartisan support and ensuring that Mainers would benefit.

"It's about more than switching from one model to another," Treat said. "We need to understand the (operation) of each model and that's not clear right now."

The state moved toward using the federal exchange after Republican Gov. Paul LePage and a Republican-led legislature refused to establish a state exchange as recommended by an advisory panel.

The insurance committee is reviewing various aspects of the state's planned use of the federal exchange in the wake of November's elections, when Democrats regained control of the Legislature.

Although federal rules would allow Maine to switch to a partnership exchange as early as 2014, Treat said she's concerned about maintaining stability at a time of great upheaval in health insurance.

"We've got to pick a path and stick to it for a couple of years," Treat said. "The exchange has to work for people, and if the state's changing its mind every couple of months, that's not helpful."

So far, 19 states plan to establish their own exchanges, seven states plan to form partnership exchanges and 25 states plan to use the federal exchange, said Colleen McCarthy Reid, the insurance committee's legal analyst.

The federal exchange is expected to be online by Oct. 1 so individuals and small businesses can sign up for state-approved and federally qualified insurance effective Jan. 1, 2014.

If the insurance committee decides to pursue a partnership exchange for 2014, the state must notify the U.S. Department of Health and Human Services by Feb. 15, Reid said.

The deadline to establish a state exchange for 2014 has passed. If the insurance committee decides to pursue the creation of a state exchange or a partnership option for 2015, Maine must notify the DHHS by Nov. 18, so the Legislature must act before this session ends in June.

The exchange is expected to serve anyone who doesn't already have health insurance. Individuals and small businesses must use the exchange if they want to take advantage of tax credits and subsidies offered under the Affordable Care Act, as well as Medicaid recipients. 

Individuals without coverage will have to pay an income tax penalty of $95 per adult or as much as $285 per family in 2014; the fees will increase each year afterward. Small businesses also face penalties if they fail to provide health benefits to employees as required under the act.

 

Staff Writer Kelley Bouchard can be contacted at 791-6328 or at:

kbouchard@pressherald.com

 

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