Maine: Affordability Study

Upshot

Gov. Janet Mills (D) signed L.D. 1778 into law which requires the Office of Affordable Health Care to conduct a study on health care affordability. The study will consider possible reforms such as a public option, Medicaid buy-in, and subsidy programs. The results of the study will inform health reforms that the state legislature can pursue in 2023 and beyond.
The report is due by January 1, 2023 and will include recommendations to inform future policymaking.

Background

Maine transitioned to its own state-based Marketplace called Maine Health in 2021, which resulted in a ten percent increase in enrollment. Four carriers offered Marketplace plans in 2022 and 66,095 individuals enrolled during the 2022 open enrollment period. Premium rates have declined for the past three years, but there will be an average increase of 11.4 percent in 2023 for full price plans.

Summary

The legislation requires the Maine Office of Affordable Health Care to analyze barriers to affordable health care and coverage. The Office will then develop a report containing legislative proposals to improve health care affordability and coverage. The report is due to the state legislature by January 1, 2023.

The Office must consider the following policies:

Creating a public option health benefit plan;
Creating a Medicaid buy-in program;
Increasing income eligibility levels to expand enrollment in Medicaid and CHIP; and
Providing state-level subsidies to populations that do not qualify for federal subsidies through the Maine Health Insurance Marketplace.

For each potential policy reform, the Office must assess the affordability of premiums, cost-sharing in the individual and small groups health insurance markets, and enrollment in comprehensive health care coverage.