Sunday, April 20, 2014
Maine is starting an $8 million-a-year effort to provide health insurance to part-time workers who don’t get coverage through employers and don’t qualify for government plans.
The state’s Dirigo Health Agency is offering federally funded vouchers to help pay insurance premiums for qualified companies and workers. The first round of employees started receiving coverage May 1.
State officials say the program will help fill one more crack in the broken health insurance system, at least until federal reforms take effect and expand coverage options in four years.
However, access to the vouchers will be limited, partly because of program restrictions and partly because $8 million will go only so far in today’s expensive private insurance market.
Officials said the money should allow them to provide insurance to about 3,000 Mainers, including workers and their family members.
“This program is very much a bridge to national reform,” said Trish Riley, director of the Governor’s Office of Health Policy and Finance.
“It’s all incremental, but it’s a positive step in the right direction.”
To qualify, an employer must have more than 50 workers and be willing to pay at least 5 percent of the insurance costs for its part-timers.
Among other requirements, qualified employees must work 35 or fewer hours a week and earn less than $32,490 a year to qualify for individual coverage.
Employees pay $30 to $330 a month for the insurance, depending on how much they earn and the amount of assets they own. Workers who also need insurance for family members have higher income limits and will pay additional premiums.
Whatever isn’t paid for by the company and the employee will be covered by the new vouchers.
“I’ve been without insurance for about two years now, and it’s been sort of a scary feeling,” said Bette Chesley of East Madison, who is in the first round of workers to receive coverage.
Chesley is a part-time rehabilitation technician for Merrymeeting Behavioral Health Associates, which has offices in Brunswick and Skowhegan. The company applied for the vouchers so it could extend health insurance benefits to part-time workers.
As a part-time employee, Chesley was not eligible for health insurance and could never afford to pay hundreds of dollars a month to buy her own insurance. Now, she said, “I only have to pay $70 a month. That’s awesome. It’s hard to believe.”
About 20 uninsured part-time workers at the company qualified for the new vouchers, said Brenda Stinchfield, the human resources director. “It was a wonderful surprise – a fantastic opportunity.”
Statewide, the funding is enough to cover about 3,000 people, assuming an average voucher of about $225 a month. It will be phased in, adding about 75 workers each month so that employers can expand coverage as they renew insurance contracts.
The federal funding also covers administrative costs and the cost of consultants who will track the effectiveness of a voucher-based program, officials said.
Dirigo Health was awarded the federal money last fall to provide insurance to people who can’t get insurance otherwise. The agency designed the program to focus on part-time workers in companies with more than 50 workers, in part because those employees don’t qualify for coverage through Dirigo Choice.
The state estimates there are 20,000 part-time workers statewide who could qualify, including some who are offered insurance at work but can’t afford it. The new program is not expected to work for every company, however.
Eligible companies have to be able to afford the additional premium costs for all part-timers, and they have to make sure that at least 75 percent of their workers participate in their insurance plans, among other things.
“The stars would have to be aligned for it to functionally work,” said Joel Allumbaugh, president of the Maine Association of Health
Underwriters and a broker who coordinates insurance plans for employers.
“There are going to be a whole lot of companies (the vouchers are) just not logistically going to work for.”
While some brokers immediately found companies that might take advantage of the program, others ran up against too many potential complications.
Allumbaugh, for example, said that it wouldn’t work for any of his clients, and that he would be concerned that a company wouldn’t receive enough slots to cover all of its part-timers, including future employees.
The state also has received questions about how the limited number of vouchers will be distributed fairly, and about the large expense of the program, said Karynlee Harrington, executive director of Dirigo Health Agency.
Vouchers will be given out on a first-come, first-served basis and the agency will be flexible in working with individual companies, Harrington said. She also said the high cost of the program, like other efforts to expand access to insurance, simply reflects the underlying problem of rising health care costs.
“People are still trying to figure out how it all works,” Harrington said. While it won’t solve the health insurance problem for every company or part-time worker, she said, “there are people out there that this program will help.”
Staff Writer John Richardson can be contacted at 791-6324 or at: