July 31, 2013

Maine exchange insurance rates due, but with snag

The coverage plans for individuals are so different from existing ones in Maine that comparing the costs of new and old may be impossible.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

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"It's an uneven playing field. There's not much of an incentive to provide discounts," Coburn said. "Maine is a very different market than New York, Boston or California, where there are a lot of different health care providers."

Since the hospitals know that insurance companies don't have much leverage, that leads to higher negotiated rates for services, which in turn means consumers pay more, Coburn said.

Whether the insurance exchange will in the long term help contain insurance costs remains to be seen, Coburn said. He said he's interested to see what Maine Community Health Options, a community nonprofit co-op, brings to the market as a nontraditional insurance provider.

In 2015, a national plan will be offered on the market, Coburn said, which might help with costs because consumers will have another choice. Also, Harvard Pilgrim insurance officials have said they intend to offer a plan on the exchange in future years.

Dr. Phil Caper of the Maine AllCare group, which advocates for universal health care, said he's skeptical that the Affordable Care Act will control costs.

"The law is unnecessarily complex and there are going to be people gaming the system," Caper said. "There will be a lot of unintended consequences."

He said the law doesn't do anything to control administrative costs, and in some ways the bureaucracy may be more expensive. For instance, the federal government is employing an army of "navigators," people to help individuals purchase insurance on the exchange. And Caper said he's seen attorneys advertise to help people figure out how they can benefit from the ACA.

"This is going to be a bonanza for people helping other people with the ACA," he said.

Joe Lawlor can be contacted at 791-6376 or at:


Twitter: @joelawlorph


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