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Sponsored by: Anthem Blue Cross and Blue Shield
Updated: December 17, 2025

Addressing the Healthcare Affordability Crisis in Maine

Mainers are facing unprecedented economic challenges. No one has been spared from higher grocery bills, increased housing and utility costs. Combined with escalating healthcare expenses, families are making difficult choices. Too many Maine people are delaying or skipping care because of cost concerns – a trend that affects community health, workforce productivity, and the local economy. It’s time to address the healthcare affordability challenge head on.

Why Healthcare Costs Keep Climbing

Denise McDonough, President of Anthem Blue Cross and Blue Shield in Maine

The first step in solving Maine’s affordability crisis is understanding what drives it. Several factors are pushing costs higher:

  • An aging population. Maine has the oldest population in the nation, leading to greater demand for complex and costly care.
  • Chronic conditions. Obesity, diabetes, and heart disease continue to rise, increasing the long-term cost of care.
  • Drug prices. Prescription drug costs – particularly for specialty medications – are growing faster than inflation.
  • Provider consolidation. When healthcare systems merge, it leads to higher prices and fewer choices.
  • Fraud, waste, and abuse. The complexity of our healthcare system makes it vulnerable to misuse.
  • Legislation. Policy changes at both the federal and state levels frequently add new costs to the system.

These pressures are being felt across Maine’s communities – from Kittery to Madawaska – and they directly affect the affordability of care for families and employers alike.

Who Can Make a Difference

Solving the affordability crisis requires collaboration across the healthcare system. Insurers, hospitals, healthcare providers, pharmaceutical companies, lawmakers, and individuals all have a role to play.

Healthcare providers must focus on value, not volume – emphasizing positive health outcomes over the number of procedures performed. Lawmakers must consider the long-term affordability implications of proposed legislation. And individuals can take an active role in managing their care by understanding their coverage, using cost-comparison tools, and taking advantage of programs that promote prevention and well-being.

How We’re Making Healthcare More Affordable

At Anthem Blue Cross and Blue Shield, affordability is at the heart of our mission to improve health outcomes and strengthen Maine’s economy. Rising costs ripple through businesses and communities, reducing productivity and well-being. That’s why we’re committed to solutions that go beyond traditional cost controls.

One of the most visible examples is our work negotiating fair and sustainable contracts with Maine’s largest healthcare systems. Over the past two years, Anthem reached new agreements with both Northern Light Health and MaineHealth – hard-fought negotiations that ensured employers and members weren’t overburdened by rapidly rising hospital costs. In each case, we stood firm for affordability. These efforts underscore our commitment to keeping healthcare accessible and financially sustainable for Mainers.

Beyond these contracts, we are:

  • Helping members manage complex care to avoid unnecessary hospital stays.
  • Offering programs that help members better control chronic conditions.
  • Negotiating lower prices for prescription drugs.
  • Paying providers based on the quality of care delivered, not the quantity.
  • Rewarding members through tools like SmartShopper for comparing prices and making informed choices.
  • Using the latest technology to detect potential fraud and improper claims.
  • Advocating for policies that support affordability and access.

Our strategy combines proven tools with innovative thinking – expanding access to high-quality care, simplifying benefits, and addressing the full spectrum of health, including behavioral and social drivers.

Looking Ahead

Historically, health plans focused mainly on paying for care and managing costs. Today, we understand that health is shaped by much more – housing, nutrition, behavioral health, and other social factors.

By working together – insurers, providers, policymakers, and patients — we can build a more affordable, accessible, and effective healthcare system for every family in Maine. 

Learn more about our efforts at anthem.com/affordabilityinmaine