AUGUSTA – It’s the one day of the year I regard as the Day of Dread. It’s not a looming birthday, April’s IRS reckoning or even an annual mammogram. It’s the day I receive our company’s annual health insurance renewal rates.

This year was especially astounding. Our rates jumped 39 percent. Even our insurance agent said it was the highest rate increase he’d seen.

His empathy was little comfort as we began the annual scramble of comparing one carrier to another, balancing good coverage with higher deductibles to hold down costs for our eight employees.

Small businesses that offer health insurance to their employees know this annual exercise all too well.

Year after year, we watch rate increases eat up revenues that could boost salaries, fund work force expansions or drive investments in innovation. Plus, these double-digit premium increases are progressively driving coverage out of reach for some.

Supporters of Maine’s new health insurance reform law, L.D. 1333, cited these challenges as the driving force behind changing health insurance rating practices and other aspects of the individual and small group markets.

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A LOT OF HOPE

There’s not a business person in Maine who isn’t hoping the new law provides some measure of relief. But we need to look beyond the intentions of the law to track whether it actually delivers on its promises.

Analysts at the Bureau of Insurance and independent policy researchers should determine if the law boosts competition by attracting new insurers into the market, and if changes in community ratings spur a greater number of young, healthy adults to purchase coverage.

It’s also important to track whether people and businesses in rural Maine fare as well in preserving affordable coverage as their southern counterparts. Will the law produce unintended consequences that make one region a loser at the expense of another?

And lastly, will those of us paying an additional $4 to $6 monthly tax on our premiums to subsidize a new high-risk pool for people with high-cost chronic illnesses see any savings from establishing this pool in the form of lower premiums?

Employers are acutely aware that rising health care costs are the single biggest threat to reviving our struggling economy. But relying solely on the changes in Maine’s new law to boost market competition and decrease health insurance costs is as short-sighted as a bow hunter carrying just one arrow in a quiver.

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We also must move forward with other key insurance reforms aimed at helping small-business and individual purchasers.

As part of the federal Affordable Care Act, states are required to establish new health insurance exchanges in 2014 as a way to create a more competitive and transparent marketplace. Exchanges can help employers and individuals comparison-shop for the best health insurance options based on their needs and resources. If a state fails to act, the federal government will step in to provide this exchange function.

Federal health reform also gives states the ability to combine their individual and small-business health insurance markets into one exchange. Doing so could boost administrative efficiency, decrease costs and add bargaining clout by pooling these smaller segments of the market.

Whether you’re a supporter of the federal health reform law or reject “Obamacare,” Maine’s small businesses and people who purchase health insurance on their own could benefit from having our own state-based exchange.

PRAGMATISM OVER POLITICS

Politics should not trump pragmatism in using every good tool and strategy to help us get better and more-affordable options.

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These reforms might make coverage more affordable, yet data from the Bureau of Insurance clearly shows the majority of our premium dollar pays for health care services.

It would be naive to expect that insurance market reforms alone will significantly rein in costs. Tackling this issue will take policies and strategies aimed at improving wellness and preventing disease, as well as reforming how we pay for care so it rewards results, not just the provision of services.

Let’s get on with insurance reform so we can focus on the real issue of reining in health care costs.

Until we attack that problem head-on, there’s little chance I’ll see an end to the annual Day of Dread. 

– Special to the Telegram

 


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