Update: The Senate adjourned today without taking action on LD 1333. Senate Majority Leader Jonathan Courtney, R-Sanford, had said on Monday that the Senate would vote today. It’s unclear why the Senate did not begin debate on the bill.

AUGUSTA — Republicans plan to use their majorities in the Maine House and Senate today to advance a bill that would inject free-market reforms into Maine’s health insurance system.

It would be the first time in this session that Republicans have relied solely on their majorities to adopt major legislation.

Democrats, who are united in opposition to L.D. 1333, say the measure would push up premiums for thousands of people, particularly older policyholders in rural Maine. Democrats plan to offer amendments that would send the bill back to committee so lawmakers could develop a bipartisan alternative.

The House, which gave preliminary approval to the bill Thursday in a party-line vote, 76-72, will vote a second time today before sending the bill to the Senate.

The final vote is unlikely to happen before Wednesday, according to the House Speaker’s Office. If Republicans win final passage in both chambers, Gov. Paul LePage plans to sign the legislation into law.

The GOP has a larger majority in the Senate, holding 20 of the 35 seats. Still, Democrats may have a better chance of amending the bill in the Senate than in the House, said Gordon Smith, a lobbyist for the Maine Medical Association, which opposes the bill.

He said political parties sometimes have trouble exerting party discipline in the Senate because the chamber’s smaller size fosters a more collaborative approach to legislation.

During the floor debate in the House last week, Republicans for the most part sat in silence as numerous Democrats stood up to ask questions or attack the bill.

Smith, who believes a bipartisan approach would produce better legislation, said the bill’s fast track — and Republican lawmakers’ silence – shows that the proposal is not well understood and has not been examined thoroughly.

“If it’s defensible, they should defend it,” he said of Republican lawmakers. “If not, they shouldn’t be supporting it.”

The “rushed” Republican plan would increase premiums for many older people, so many would drop coverage, said Rep. Sharon Treat, D-Hallowell, the ranking House Democrat on the Legislature’s Insurance and Financial Services Committee.

Democrats plan to offer an amendment that would include the free-market reforms but also subsidize premiums – through the federal Affordable Care Act – to protect older people whose insurance costs would increase substantially.

Sen. Roger Katz, R-Augusta, a moderate Republican, said Monday that there appears to be consensus in the Senate Republican caucus to support the bill, and he is convinced that it would lower premiums for everyone.

The current system is unsustainable because insurance is too expensive for most Mainers, said Senate Majority Leader Jonathan Courtney, R-Sanford.

He said regulations aimed at protecting older people from high premiums have simply driven young people out of the market, causing high premiums for everyone.

“This system is broken and it’s time to take a different approach,” he said.

L.D. 1333 would overhaul the health insurance market for about 40,000 people – those who buy independently or through employers whose companies have 50 or fewer workers.

Still, it would affect almost every policyholder in the state because it would be funded by a tax on premiums of as much as $4 per person per month.

The bill would allow companies from every other New England state except Vermont to sell insurance in Maine. Current law prohibits out-of-state companies from selling insurance here. Vermont is excluded because it is moving toward a universal health care system.

The bill would give insurance companies more leeway in how much they can charge policyholders based on age and place of residence.

Critics say it would create winners and losers. While it would lower premiums for young people, by next year older people could be paying three times more for their policies than young adults. Current law limits the ratio to 1.5 to 1.

The bill would also prohibit insurers from rejecting people for pre-existing conditions. Those people could get the same insurance plans as everyone else.

The bill would create a nonprofit group, the Maine Guaranteed Access Reinsurance Association, which would subsidize the insurance of people who have high medical costs.

People’s private insurance carriers would cover their first $7,500 in medical expenses per year. Using revenue from the $4 per-person tax, the nonprofit would cover 90 percent of the next $25,000 in expenses, and 100 percent after that.

By reducing the insurers’ cost of covering the sickest people, the plan would allow the companies to lower premiums for everyone, supporters say.

The bill also would repeal a state law that prohibits insurance companies from requiring policyholders to go to hospitals in other parts of the state for medical procedures.

Rep. John Martin, D-Eagle Lake, said that provision would harm people in northern Maine because it would make them travel to Bangor for medical help. He said he may propose an amendment that would strip that provision.


MaineToday Media State House Writer Tom Bell can be contacted at 699-6261 or at: [email protected]