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May 13, 2013

Two providers file for state's health exchange

Just two health insurance providers have signed up to offer products on the federally run health care exchange scheduled to start in Maine on Jan. 1.

The Bangor Daily News reported Maine Community Health Options and a collaboration between Anthem Blue Cross and Blue Shield and MaineHealth are the only two organizations to submit plans to offer insurance products on Maine's exchange as part of the Affordable Care Act. The limited number of proposals is a disappointment to consumer advocates who had hoped new out-of-state insurers also would offer products here.

The collaboration between MaineHealth and Anthem Blue Cross and Blue Shield is being criticized by health care providers outside of the MaineHealth network, the paper reported. Chuck Gill, vice president for public affairs at Central Maine Healthcare, called the plan "purely a competitive move by MaineHealth" and said it undermines the Affordable Care Act's intent to improve access to affordable health care.

In a filing statement, Anthem and MaineHealth wrote they would develop products that would "enable consumers to have access to a select group of hospitals and providers in Maine," although an Anthem spokesman would not confirm to the paper which providers are included in the proposed network, how it was developed or pricing details.

In a letter to the Maine Bureau of Insurance, Anthem projected that limiting the provider network — in a "narrow network" plan — would produce double-digit rate reductions from Anthem under the expectation that the number of patients treated will increase.

Federal regulators will have the final decision about which plans will be offered through the state health care exchanges. Maine's insurance bureau will, in the meantime, review the two plans submitted by last Friday's deadline and make recommendations to federal officials.

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