The Health Coverage, Insurance, and Financial Services Committee on Tuesday considered a bill that would codify consumer protections under the Affordable Care Act into state law.
The goal is to protect Mainers from future efforts to dismantle the ACA. But some insurance providers are concerned that the bill would only protect access, and not affordability.
The bill was sparked by attempts over the past several years to undermine the ACA — most recently, a federal court ruling in Texas last December that found the law to be unconstitutional. The ACA is still in effect while that case is under appeal. But as a safeguard, Democratic leaders in the Maine Legislature have introduced an emergency bill to put ACA protections into state law.
“The idea is Mainers won’t get left in a lurch if the ACA goes away,” says Senate President Troy Jackson.
The bill, LD 1, would require that insurance plans cover essential health benefits such as maternity care, mental health care and substance use treatment. It would allow children to stay on their parents’ insurance plans till age 26. LD 1 would prohibit insurers from charging substantially higher rates to seniors because of their age, and bars denying coverage to people with pre-existing conditions, such as Kate Brogan’s five-year old son, who has type 1 diabetes.
“Like all type 1 diabetics, my son requires multiple injections of insulin every day to survive. There’s no known cause for type 1 diabetes, and no known cure. Health insurance has kept my son alive for past two years,” she says.
Brogan was one of several Mainers who rely on ACA coverage and its protections who testified in support of LD 1 during a public hearing Tuesday. The bill also has the backing of Gov. Janet Mills and several health and advocacy organizations, including the Maine Medical Association, Consumers for Affordable Health Care and the Alliance for Addiction and Mental Health Services.
Alliance for Addiction and Mental Health Services Executive Director Malory Shaughnessy reminded the committee that it was the ACA that offered the first protections for people with behavioral health illnesses.
“Prior to this point, people with behavioral health illnesses could be discriminated against legally and be barred from having coverage in health plans,” she says.
No one at the public hearing testified against the proposal. But several insurance organizations testified neither for nor against.
Katherine Pelletreau of the Maine Association of Health Plans says insurers are concerned that the bill only includes ACA protections for access, and not affordability, because if fails to address components such as cost sharing reductions and subsidies.
“If the ACA is repealed, those issues are going to need to be addressed, as the coverage that’s created by this bill raises costs to a point that would be largely unaffordable for many Maine people if those affordability aspects aren’t there,” she says.
Kim Cook of insurance co-op Community Health Options suggested that the committee amend the bill to possibly include a requirement that all individuals have health insurance and create a funding mechanism so that all income levels can purchase coverage.
The committee will consider whether to include affordability provisions in the bill during a work session on Feb. 7.
Originally published Jan. 30, 2019 at 5:30 p.m. ET.
