June 30, 2012

Decision's impact stretches across Maine

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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


Meanwhile, Department of Health and Human Services Commissioner Mary Mayhew released a statement saying the administration would move forward with the MaineCare cuts. It will notify the federal government about the changes, but it won't seek special waivers, a spokesman said.

"The language of the Supreme Court decision affirms that Medicaid expansion cannot be mandated and that states have the flexibility to manage their Medicaid program without risking the loss of existing matching federal funds," Mayhew said.

The dispute centers on a section of the ruling that says states cannot be required to expand their Medicaid programs in 2014, as the law had required. Under the law, states could have lost huge amounts of federal health care funding if they refused to expand their Medicaid programs in 2014.

Democrats argued Thursday that the ruling only applies to future expansions. The Lepage administration took the position that it also allows the state flexibility to change existing coverage levels.

Republican Attorney General William Schneider said the protection of states' rights was a positive piece of an otherwise diappointing decision. But he carefully avoided taking a position on the pending budget cuts in a statement released after the ruling.

"The expansion of Medicaid on the backs of state budgets through all-or-nothing bullying tactics was rejected by the court," he said. "We are carefully reviewing the decision to evaluate how this will specifically impact Maine."

Business sector has mixed reaction to health care ruling

The Supreme Court's decision to uphold the Affordable Care Act drew mixed reaction from Maine's business community, but some business owners interviewed said they were glad to have the law's legal status resolved.

"Nothing really has changed. What was the law yesterday is the law today," said Peter Gore, vice president for advocacy and government relations for the Maine Chamber of Commerce. "A lot of employers went into a holding pattern, waiting for what the court would do. Employers will now begin to see how the law will affect them and can make choices."

The biggest impact, business owners said, is that the law requires businesses with 50 or more full-time equivalent employees to provide health insurance for all workers by 2014 or face penalties. Businesses with fewer than 50 employees -- about 29,400 in Maine, more than 97 percent of all businesses in the state -- are exempt.

In Maine, 47 percent of residents get their health care coverage through their employers, just below the national rate of 49 percent, according to the Kaiser Family Foundation.

Small businesses will be able to shop for less expensive health insurance on state exchanges, but some with 25 to 50 employees might think twice about expanding so they don't have to provide insurance plans.

"If a business is threatened by extinction by this, there will be a backlash," said Dick Grotton, president and chief executive of the Maine Restaurant Association. "There are some people who will say 'I have 49 employees and I'm never going to hire again.' That's an emotional reaction. We need to wait another year and a half to see how this all pans out."

Grotton said the average restaurant employs about 40 to 45 employees, but a restaurateur who owns more than one establishment would probably qualify as a larger business and be required to provide health care coverage for all workers.

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