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January 2, 2019

First bill of new session: Protect health care coverage for all Mainers

Courtesy / Senate Democrats Office
Courtesy / Senate Democrats Office
Senate President Troy Jackson, D-Allagash, introduced LD 1, "An Act to Protect Health Care Coverage for Maine Families," as the first bill of the 129

Gov.-elect Janet Mills, Senate President Troy Jackson, D-Allagash, and House Speaker Sara Gideon, D-Freeport, wasted no time changing course from Gov. Paul LePage's health care policies.

On Monday they announced the first bill of the 129th Legislature: LD 1, "An Act to Protect Health Care Coverage for Maine Families." The bill, introduced by Jackson, seeks to require insurance companies to include basic patient protections in health care plans offered in Maine.

According to the summary posted on the Legislature's website, the bill seeks to ensure that consumer protections related to health insurance coverage included in the federal Patient Protection and Affordable Care Act are codified in state law:

  • It makes clear that individual and group health plans may not impose any preexisting condition exclusion on an enrollee. The bill does permit a carrier to restrict enrollment in individual health plans to open enrollment and special enrollment periods established in rule.
  • It clarifies that carriers offering individual or group health plans may not establish lifetime or annual limits on the dollar value of benefits. The bill specifies that the provision prohibiting annual limits on the dollar value of benefits applies to the dollar value of essential health benefits as determined by the Superintendent of Insurance.
  • It allows children, until they attain 26 years of age, to remain on their parents' health insurance policy.
  • It changes the maximum rate differential due to age that may be filed by the carrier to the rate differential that is permitted under the federal Patient Protection and Affordable Care Act.
  • It requires that, at a minimum, health plans cover essential health benefits that are substantially similar to those benefits required for health plans subject to the federal Patient Protection and Affordable Care Act as of Jan. 1. The bill directs Maine Insurance Commissioner Eric Cioppa to define essential health benefits in rule and designates those rules as major substantive and subject to legislative review and approval.

Democratic leadership: 'Health care a basic human right'

"I refuse to stand idly by as forces in Washington and elsewhere work to strip Maine people of critical coverage for pre-existing conditions and other essential health benefits like mental health and maternity and newborn care," Mills said in a news release. "Maine can do more to strengthen its laws and align them with the protections guaranteed under the Affordable Care Act. That's why my administration will move immediately, in concert with the Legislature, to help protect Mainers with pre-existing conditions, regardless of what happens at the federal level."

Jackson, in a statement sent to Mainebiz, said "health care is a basic human right."

"It's about the freedom to have control over your own life, your own future," he said. "With health care increasingly under attack, it's our job as state lawmakers to do everything in our power to protect the health and well-being of Maine people, starting with this legislation. We must also must work together to lower health care costs, increase access to care and strength the quality of coverage."

Jackson sponsored similar legislation last session, which was ultimately vetoed by the governor. This session's bill, he said, comes in response to the recent ruling out of Texas threatening the constitutionality of the Affordable Care Act and the patient protections that come with it.

While the ACA will remain in effect as the court decision undergoes an appeals process, the Democratic leadership said they do not want to take chances on losing the federal law's patient protections such as essential health benefits and measures to prevent insurance companies from charging seniors much higher premiums.

"Our goal is affordable and accessible health care for every Maine family," Gideon said. "From the closings of many of our rural hospitals to the outrageous cost of prescription drugs to a crippling opioid epidemic, the problems are real and they are staggering. This lack of access is causing lasting damage to not just individuals, but to our entire economy and it is time we took action."

Gideon described the proposed bill as "Step 1" of the new administration and lawmakers' efforts "to address these issues and make real and lasting change" during the first session of the 129th Legislature, which will reconvene today for Mills inauguration as governor.

ACA remains in place during appeal of Texas ruling

Meanwhile, U.S. District Judge Reed O'Connor of the Northern District of Texas said over the weekend that the ACA should remain in place as appeals to his decision striking down the law weave their way through the courts.

On Dec. 14, O'Connor sided with 20 Republican states in a lawsuit against the ACA (including Maine, as a result of Gov. Paul LePage joining the lawsuit), ruling that the ACA is unconstitutional due to zeroing out of the individual mandate penalty, which takes effect on Jan. 1.

Fierce Healthcare reported today that O'Connor issued a stay and partial final judgment on the ruling, setting the stage for appeals while offering clarity requested by Democratic attorneys general of 17 states following his decision earlier this month. The states said clarification was needed before the beginning of the year when the individual mandate penalty officially ends to avoid "extraordinary disruption."

The judge agreed, setting the stage for his ruling to be appealed to the Fifth Circuit Court of Appeals, Fierce Healthcare reported, adding that it's possible the case could wind up in front of the U.S. Supreme Court.

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