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January 7, 2019 19 on '19

Health care: For Maine's health care, a positive prognosis

Photo / Tim Greenway Kevin Lewis, president and CEO of Community Health Options

Despite a decline of over 5% from 2018 to 2019 in the number of Mainers obtaining health insurance through the Affordable Care Act, Community Health Options President and CEO Kevin Lewis says he is “cautiously optimistic” about the year ahead.

A total of 71,577 residents enrolled in 2019 ACA coverage by the deadline, compared to 75,089 who enrolled in 2018 plans under the federal program.

Lewis believes CHO, a nonprofit insurer offering a dozen ACA plans in Maine, will see a slight decline in members when enrollment data is finalized. That's partly due to the decline statewide, and partly because of the return of Anthem Blue Cross and Blue Shield to the ACA marketplace, bringing the number of insurers to three. (In 2018, only CHO and Harvard Pilgrim Health Care offered ACA plans.)

The falloff in Maine's ACA enrollment mirrors the nationwide decline of 4%, which some experts blame on a lack of promotion of the program.

A ruling in December by a federal judge in Texas that the ACA is unconstitutional has also created uncertainty about the program's future and a “chilling effect” on its public perception, Lewis says.

Insurance costs are an ongoing worry for consumers, he adds, noting that CHO's premiums for 2019 will increase from 2018 by an average of 0.9% across all individual ACA plans. “There's great concern about cost. Health insurance premiums continue to be on people's minds,” he says.

Still, he says, “our open enrollment results looks really solid. I'm confident we'll have a good 2019.”

“We continue to see a shift toward Bronze (a category of low-cost ACA plans), but people are choosing one of our most benefit-rich Bronze plans,” Lewis says. “That tells us people are at least looking beyond premiums.”

With Gov. Janet Mills' pledge that Maine will participate in the federal government's expansion of Medicaid benefits under the ACA, Lewis sees another upside for 2019.

“I'm optimistic about Medicaid expansion,” he says. “We think it's important for Maine, so that there are no gaps in the health care spectrum and people can get coverage when they need it. And it's better for the overall risk pool.”

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