Tuesday, March 11, 2014
By LINDA SANBORN and SHARON TREAT
Many of us are waiting to hear the decision by the Supreme Court on the legality of the individual mandate and the Affordable Care Act.
A mother holds her daughter as she awaits a flu shot in Duxbury, Vt., in 2009. In Maine, more than 226,000 people received immunizations and other preventive care services over the last year with no out-of-pocket costs, thanks to the Affordable Care Act, two legislators say.
2009 File Photo/The Associated Press
Yet even though this decision will affect how health care reform progresses, it will not be the ultimate game changer. The "game" will play out in state legislatures across the nation, and it is up to the states to determine the future of health care reform.
We know that the ACA is already saving lives right here in Maine.
Take the story of Debra, a Maine resident, and her family.
Debra writes, "I am a breast cancer survivor with two sons in college. My youngest son is 19 and my eldest is a colon cancer survivor at 23. Allowing children to be on their parents' health insurance until age 26 is a huge blessing to us during very difficult times.
"My son Justin was diagnosed with a very large and very messy tumor at age 21, three months before getting his undergraduate college degree. Without the new rules he would have been off our policy after graduation just in time for his second surgery and second round of chemotherapy.
"He would then have had a pre-existing condition, and it would have been difficult to get any insurance. I am so grateful for the new health care policies."
There are many families like Debra's. Because of the ACA, 7,329 young adults in Maine now have health care coverage through their parents' plan.
Seniors have also benefited -- 11,892 older Mainers each saved an average of $1,384 on prescription drugs purchased through Medicare.
Did you or a family member go to your doctor sometime this past year and receive a preventive service without a copay or deductible? More than 226,000 Mainers have received preventive services such as well visits for children, cancer screenings, smoking cessation counseling and immunizations, with no out-of-pocket cost -- all courtesy of "Obamacare."
Mainers will not want to give up these hard-won successes, nor will it be economically beneficial for them to do so. Access to preventive health care and evidence-based care of chronic disease is cost-effective.
Even as we wait for the Supreme Court ruling, Maine is moving forward (spurred by policies and grants in the ACA) with promising trials of payment reform such as an affordable care organization, the Beacon Community Program, run by the Eastern Maine Healthcare System. Many pilot patient-centered medical homes across the state are working to raise the quality of care and provide it in an efficient and cost-effective way.
We are of the opinion that repeal would be a mistake. Over the years, Maine has put in place consumer protections that have brought fairness and security to the health insurance system. While some of those protections were repealed by the Republican majority in the recent legislative session, fortunately for patients, medical providers and small businesses, the ACA was already in place to fill in the gaps.
The ACA incorporates many of the best practices already followed in Maine and other states -- it just makes those policies better by providing protections no matter where you live, or what job you have, or whether you are a man, woman or child.
These are protections that most people value and see as necessary. People should never have to go bankrupt because of illness or injury, or die of a treatable disease. Insurers should use money spent on premiums to pay doctors and hospitals -- not for excessive executive pay or profits. Women should never be discriminated against when seeking health care or insurance coverage.
If the ACA is upheld, Mainers will have the opportunity to shape the way the law is implemented so that our small businesses and families can easily purchase affordable, high-quality health insurance.
If any part of the ACA is overturned, then nothing should stop us from forging ahead to carry out the goals of the law:
• Making preventive care the first step toward good health.
• Stopping the worst abuses by insurance companies, such as revoking insurance after you get sick or refusing to insure pre-existing conditions.
• Making health care affordable as well as available.
Maine was leading the way in providing increased access to health care, improved quality of care and payment reform, and we can lead the way again. No matter what happens with the Supreme Court decision, we cannot let the profits of the health insurance industry have priority over the health and welfare of our people.
Ensuring health care for everyone is essential to the well-being of our people and the future of our economy. We're in this for the long haul, and we hope you will work with us to make it happen.
Rep. Linda Sanborn, D-Gorham, serves on the Legislature's Health and Human Services Committee, and Rep. Sharon Treat, D-Hallowell, is the ranking Democrat on the Insurance and Financial Affairs Committee.
– Special to the Telegram