Gov. Mills’ Health Care Coverage Act is a significant proposal to help Mainers afford health coverage. Creating a state-based insurance exchange is a tested idea that enjoys bipartisan support nationally from states as different as Idaho and California.

By maximizing state control, studies show that these states with their own exchanges do better than those that use the federal exchange – they enroll more uninsured people, control premium increases better and provide more marketplace competition and choice for consumers. By working closely with insurance brokers and consumer groups, state-based exchanges have effectively targeted and enrolled younger people and those hard to reach but very much in need of affordable coverage.

And Maine’s proposal to merge the individual and small-group markets can bring more purchasing power to negotiate better premium rates. Coupled with the initiative to access federal dollars to provide reinsurance, the bill protects health plans from the costs of extraordinary medical claims from a few very sick enrollees, thereby preventing unpredictable premium spikes for all consumers. Importantly, the plan would provide consumer protections by simplifying health plan coverage (making it easier for consumers to shop) and by providing initial visits for primary care and behavioral health at no out-of-pocket cost to the consumer.

The ideas in this proposal have been proven effective in states across the country, and packaging these initiatives together, as this bill does, will return Maine to its place of leadership in health reform.

Trish Riley


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