Maine Health Insurance Exchange

How Maine Residents Will Be Affected by the Patient Protection and Affordable Care Act (ACA)

 The Patient Protection and Affordable Care Act (or ACA), was enacted in March of 2010. The Mission of this Act was to increase the number of insured individuals, improve health care quality, lower costs, and reduces health disparities through an innovative, competitive marketplace that empowers consumers to choose the health plan and providers that give them the best value. Individuals have previously had to rely on large corporate employers to provide access to affordable health care options, and if you were not employed by a large employer (those with more than 100 employees) you were simply denied access to affordable health insurance options.

 The estimated percentage of people in Maine who have no health insurance is believed to be 10% of the population. This amounts to roughly 140,000 individuals with no assistance with their health care needs. Approximately 16,000 of those individuals are children. The Affordable Care Act gives hardworking families in Maine the security they deserve.

 The United States Supreme Court has upheld the Patient Protection and Affordable Care Act (or ACA) and states have to adhere to several provisions of the Act. One of the primary requirements is the need for each state to create and operate a Health Insurance Benefits Exchange for their residents. Maine has received approximately $6.8 million in grants for research, planning, information technology development, and implementation of Affordable Insurance Exchanges. Additionally, Maine was among the consortia of New England states to receive the “Early Innovator” cooperative agreement for a total of approximately $35 million.

Health Insurance Benefits Exchanges are government agencies or non-profit groups that will organize and oversee private markets for buying health insurance. These groups have previously had to rely on large corporate employers to provide access to affordable health care options. Those that were not employed by large employers (those with more than 100 employees) were simply denied access to affordable health insurance options. Some of these groups have received some sort of assistance from Medicaid, Medicare or other governmental programs. Others have simply gone without health insurance coverage. The exchanges will offer a choice of certified health plans from which individuals and small businesses can choose.

On November 16, 2012, Governor Paul LePage wrote in a letter to federal officials that Maine would not be pursuing efforts to implement a state-based health insurance exchange.  Instead, they are going to allow the federal government to run the Health Insurance Benefits Exchange, which will be established and administered in conjunction with a non-profit organization. This was the alternative provided for states that could not or would not implement their own exchange solution.

As of January, 2014, all residents of Maine will be able to join the new marketplace and purchase health insurance coverage for their families in much the same way large companies’ employers have been able to do for years.  The next step is making sure these previously uninsured families and / or individuals have the information they need to make educated choices that will make all the difference the day an unexpected occurrence such as serious illness or injury befalls their family.  Making the best possible choice will protect your families’ physical and also financial health.

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