BRUNSWICK – With little public notice and discussion, a bill to roll back consumer protections, increase costs, raise new taxes, create new bureaucracy and lower health benefits for many could soon be law.

L.D. 1333 allows out-of state insurance companies to sell plans here with fewer benefits. It allows higher premiums for older people and requires the sick to get coverage in separate plans.

Proponents say getting the sick out will lower premiums for all, but offer no data. To support this scheme, L.D. 1333 disrupts the market and raises taxes on every man, woman and child who has health insurance.

Who will see lower premiums and by how much? How high will premiums grow for those over 40 or chronically ill?

Who among us knows when an illness, accident or unexpected birth outcome will hit? And when it does, don’t we want coverage we can rely on and afford?

Websites tout attractive base rates out of state. But insurance companies increase those rates based on age, gender and health, raise deductibles and limit benefits.

The insurance company trade association reports the average annual single premium in Maine cost $4,061 in 2009 and $3,427 in New Hampshire, while average family premiums were higher, $7,672 versus $7,260 in Maine.

Our nation has a long tradition of helping each other. In our early days, many joined wagon trains and headed out together across new frontiers.

When a wagon wheel broke, all pitched in and fixed it. But there were adventurers who left, seeking promised fortune in the gold rush.

If too many left, the wagon train had only the old and frail, unable to fix those wagons.

And that’s how insurance works — the larger the group, the more costs can be shared to keep costs affordable for everybody. If the young and healthy go out of state, costs become unaffordable to those left behind.

Suppose our adventurer gets sick, losing his fortune. What happens?

He must get coverage in a high-risk pool, often with lower benefits and premiums about twice the going rate. He may have to wait for care. And all high-risk pools require significant subsidy.

According to the GAO, in 2008, high-risk pool premiums covered 54 percent of costs. Taxes on insurance companies paid 23 percent, federal grants paid 2 percent and taxpayers and others paid an additional 21 percent of the costs.

L.D. 1333 is a modified risk pool called a Guaranteed Access Plan, or GAP — it still makes sick people get coverage there — but premiums are the same as the individual market.

If the GAP is filled with the sick, its costs will be higher. If premiums are protected, how is the GAP affordable? It must be deeply subsidized and/or have limited benefits.

The plan is modeled on an Idaho program, but Maine is an older state. Idaho charges higher premiums and still requires deep subsidies, limits benefits and has a year wait for pre-existing conditions. Individuals pay $10,000 to $20,000 out of pocket and pay co-pays for services like prescriptions.

Benefits are limited, to $2,000 per year in outpatient expenses, for example. And the plan terminates when you hit lifetime limits as low as $500,000.

Those who hit the cap can switch plans, but that’s hard to do when you’re in the middle of treatment. Who guarantees you have the same doctors?

Reducing health insurance premiums requires reducing the cost of health care. L.D. 1333 takes us backward, not forward, and repeals a number of mechanisms now in place in Maine to address costs.

Premium payers require relief. Some approaches include:

n Maine could provide more tools to better negotiate what we pay for health care.

n A law enacted earlier creating special, lower-cost products for younger people needs to be reviewed and implemented.

n We already have Dirigo Health, providing subsidized health plans for individuals and small business. Ironic that L.D. 1333 increases taxes, a much-maligned aspect of Dirigo, and creates another agency to administer its plan.

It will cover far fewer people than Dirigo. Dirigo negotiated base rates for individuals with no increase and a 2 percent increase for small businesses, and provides health coverage through several products to nearly 15,000 people. Yet Dirigo’s funds are being cut.

Idaho’s plan, the model for L.D. 1333, enrolls fewer than 1,400, whose average age is 47.

L.D. 1333 provides no data to document costs, and if and how it will work.

Without needed, independent and up-to-date actuarial analysis of its financing, L.D. 1333 is an empty promise.

– Special to the Press Herald