June 30, 2012

Decision's impact stretches across Maine

Ruling is a boon to some uninsured, an irritant to others

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Opponents of President Obama’s health care plan, tea party activists Jenny Beth Martin of Atlanta, rear left, Keli Carender of Seattle and David Walls-Kaufman of Washington, get in a heated discussion with health care supporter Michael Paysour of Washington in front of the Supreme Court after the ruling on the Affordable Care Act was announced upholding most of the plan.

Washington Post photo by Katherine Frey

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9,000: The estimated number of young adults who now have health insurance due to a provision in the law that requires insurance companies to provide coverage to young adults up to age 26 on their parents’ health insurance plans.

187,251: The number of people with Medicare who in 2011 received free preventive services – such as mammograms, colonoscopies and annual wellness visits with their doctor.

$11 million: The amount that people on Medicare have saved on prescription drugs since the law was enacted.

$2,579,922: The total value of rebates that will go to 5,600 families with private health insurance this summer due to a provision in the health care law that requires insurance companies to spend at least 80 percent of premium dollars on health care and quality improvements instead of overhead, executive salaries or marketing.

$463: The average rebate to each family.

41: The number of previously uninsured residents of Maine who as of April 2012 were locked out of the coverage system because of a pre-existing condition and are now insured through a new plan for such people created under the new health reform law.

Source: U.S. Department of Health and Human Services


Rachel Sukeforth of Litchfield is one of about 125,000 Mainers -- 10 percent of the state's population -- without health insurance.

In 2014, under the Affordable Care Act, the number will drop dramatically.

Some uninsured Mainers could be added to MaineCare, Maine's Medicaid program, because of expanded eligibility rules. Some could be added to employers' coverage plans because more businesses will be required to provide them. And many will be required to buy their own private insurance through a new government-run exchange that will provide subsidies for people who qualify.

Sukeforth, for one, is looking forward to being insured again.

Sukeforth works as a lab assistant for a small business that does not offer insurance coverage. She can't afford hundreds of dollars a month for private insurance now, but hopes the coverage mandate will bring costs down.

"I was a little worried that they were going to strike it down," she said. "I'm 27. My generation is struggling to find jobs and starting families and the fact that we're going to have access to affordable insurance, hopefully this will make things easier for us."

Ethan Francine of Topsham, on the other hand, was disappointed Thursday.

The 25-year-old college student is currently on his parents' plan, but may soon be uninsured. He had hoped the law would be struck down because he doesn't want to be forced to buy health insurance.

"It seems like it's taking away from freedom and the American way of life," he said.

Bringing coverage to the uninsured is the basic goal of the law and perhaps the most important way it could ultimately reduce the cost of insurance, advocates say.

That's because the uninsured tend to avoid doctors and preventive care, waiting until they are so sick they have to go to the emergency room for expensive acute care.

Much of the cost of emergency room care is paid for by everyone else through higher medical fees and higher insurance premiums. Maine's medical community estimates the cost of caring for the uninsured adds as much as 30 percent to the cost of health care in the state.

Political fallout over court decision has already begun

The fallout from the Supreme Court decision is sure to stir up the partisan battles over health care in Maine's state capital.

In fact, it started within hours of the ruling Thursday.

Democratic legislators hailed the decision and said it will prevent Maine from going through with plans to cut off some 27,000 from coverage by MaineCare, the state's Medicaid program.

"These were all people who were going to lose their health care if the Affordable Care Act went down, no questions about it," said Rep. Sharon Treat, D-Hallowell. "We're really lucky in Maine that this law was upheld."

While the Affordable Care Act allows for waivers to make cuts in special cases, it requires states to continue with existing levels of coverage. Democrats said that leaves a $10.7 million hole in the Maine budget for the fiscal year that starts next week.

The LePage administration had a different view -- and a different interpretation.

Gov. LePage blasted the decision in a written statement.

"This is a massive overreach by the federal government, and is infringing upon the individual choices that we, as Americans, have in pursuing our own American Dream ... This massive tax hike will only destroy the American economy as it forces us over the financial cliff," said LePage.

(Continued on page 2)

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