Federal Government Approves Maine’s Plan to Boost Health Insurance for Small Businesses

Maine’s State Innovation Waiver — part of Governor Mills’ 2020 health reform legislation — uses state-of-the-art innovations to stabilize the market and reduce costs.

Governor Janet Mills announced today that the federal government has approved Maine’s plan to improve health insurance coverage for small businesses by implementing new universal policies to help increase coverage and reduce premium increases, which will save people and workers in small businesses. ‘no. health care costs.

The US Centers for Medicare and Medicaid Services notified the Maine Bureau of Insurance today that it has approved Maine’s request for a State Innovation Waiver. The removal is due to Governor Mills’ health care reform bill – Made for Maine Health Coverage Act. Health insurance premiums are rising in Maine in 2023, the same as they are in the rest of the state, but Maine’s state repeal will prevent them from rising as much as they would have otherwise, making the premiums 8 percent below the market and 6 percent lower. lower in the minority market than they would have been without the exclusion. For example, a 40-year-old with an individual plan could pay $99.31 more in their monthly premiums in 2023, but for withdrawals the premiums would increase by $64.35, saving $34.96 or about $420 a year, not counting federal financial aid. ; while a 40-year-old with a comparable group plan could pay $44.02 more each month in 2023, but with the deduction the increase in premiums would be $15.92 — a savings of $28.10 or more than $190 a year.

The same market supports individuals who purchase insurance on their own with Federal financial assistance while the small group market supports employers with 50 or fewer employees.

Under the changes approved now, Maine will combine its private and small group health markets into a single, integrated market starting in 2023. This merger will stabilize the market and allow for Federal funding through the Maine Guaranteed Access Reinsurance Association (MGARA) – which has established Maine private market starting in 2019 – to be expanded to the small group market for the first time. Reinsurance provides a direct benefit to consumers by paying a portion of provider claims that would otherwise have been paid by consumers through higher premiums. The change is expected to reverse the upward trend and decline in enrollment in the small group market while continuing to moderate inflation in the individual market. Maine’s small businesses have been helping to pay for the MGARA program through monthly checks with all Maine health insurance. Adding a small group market to the MGARA program will also allow Maine’s small businesses to benefit from the program.

It will also help insulate Maine’s small businesses from the rest of the world increase in health care costs due to rising costs, shortages in health care workers due to the pandemic, the continuing need for COVID-19 care, and the loss of financial support related to the pandemic. By 2023 wages in Maine could increase by an average of 3.4 percent for small businesses, which is much lower than the projected increase for small businesses in states like New York.16.5 percentVermont, Vermont14.6 percent (PDF)and Rhode Island (11.5 percent (PDF)).

Maine is the first state in the country under the Affordable Care Act’s 1332 waiver program to offer Federally funded services to employers and individuals. MGARA, supported by Federal funds and health insurance premiums, pays a portion of the cost of high-cost health care bills, lowering and stabilizing health insurance premiums.

“Small businesses are the backbone of Maine’s economy, providing jobs and benefits like health insurance to thousands of Maine residents. Ensuring that health insurance is affordable is important, not only for the health of small businesses but also for the health of their employees.” work, ” said Governor Janet Mills. “Our universal health reform legislation will strengthen the health insurance market and lower the cost of health insurance for small businesses, and will further my Administration’s work to make health insurance affordable for businesses and hardworking workers.”

“I recently helped my oldest son buy a flea market in New England and I couldn’t believe how much more it cost than what he would have paid in Maine,” said Sen. Heather Sanborn, co-chair of the House Health Coverage, Insurance and Financial Services Committee.. “I am proud of the work of the Legislature and the Mills Administration to reduce rates and look forward to extending these powerful tools to help people who work in Maine’s small businesses.”

“The Health Coverage, Insurance and Financial Services Committee worked closely with the Mills Administration to implement this initiative to help our small businesses be able to afford to support their workers,” he said. Said Rep. Denise Tepler, chairwoman of the House Health Coverage, Insurance and Financial Services Committee.. “I am very pleased that this plan can move forward to increase Maine’s success with reinsurance by lowering our rates in the market.”

“The state’s approval of Maine’s health coverage plan is good news for Maine consumers and small businesses,” said Ann Woloson, Executive Director of Consumers for Affordable Health Care. “It will be easier and more affordable for Maine people to get the health care they need by reducing costs using the tools already demonstrated in our state. We look forward to these changes in 2023 that the Mills Administration and Legislature have made possible.”

Maine’s plan also received it Support for national health organizations (PDF) such as the American Cancer Association’s Cancer Action Network, the American Heart Association, and the American Lung Association, among others.

Governor Mills has made it a priority to help Maine’s small business owners and workers access health care, recognizing that small businesses are the backbone of Maine’s economy and the main source of health insurance for Maine residents.

Through his Maine Jobs & Recovery Plan, the Governor has established the Small Business Health Insurance Premium Relief Program which lowers the cost of monthly health insurance premiums for small businesses and their employees. Under the program, health insurers receive financial assistance to reduce the costs of their small customers by $ 50 per employee per month and up to $ 130 per month to support families. In May 2022, 5,841 Maine Small Businesses received premiums through the program. This represents a total of 46,802 Mainers (employees and their families) who are receiving reduced income. $2,066,140 in small business loans went to small businesses in May, and more than $14 million has been awarded in the first six months of the program. The program is expected to continue until April 2023.

The Governor is committed to providing affordable, quality, and accessible health care to all Maine residents. As his first act on his first day in office, Governor Mills signed legislation to expand Medicaid (MaineCare), in line with the will of the people of Maine as expressed in the 2017 vote. Today, more than 95,000 Maine residents have access to health care through in expansion, and Maine’s non-adult population. he has fallen about 25 percent, from 9.1 percent in 2018 to 6.7 percent in 2020. In his first year in office, he restored a program that helps low-income seniors afford prescription drugs.

In his second year in office, Governor Mills presided over what became the best epidemic in the United States, according to The Commonwealth Fundand Maine received an “A” as of 2022 Analysis of the National Business and Economic Review. Maine received these strong reviews despite being considered one of the states most at risk from COVID-19 due to its population and economy, according to the Oxford Economics.

In his third year, Governor Mills received federal approval and launched it CoverME.govThe Maine Health Insurance Marketplace, which was also authorized by the Governor Made for Maine Health Coverage Act. Under this law, the State of Maine operates its own Health Insurance Marketplace, which better supports health insurance for Maine residents and their needs. For its first registration of 2022, CoverME.gov registered 66,095 people, an increase of 10 percent over 2021, which reversed the decrease in Marketplace elections from 2017.

The Made for Maine Health Coverage Act it has also reduced out-of-pocket costs for primary care and practices as well as co-payments and deductibles Standard Choice plans.