September 29, 2013

From political to personal, new health care law kicks in Tuesday

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

In two days, the health insurance marketplace will open for business, a pivotal moment in the short history of the Affordable Care Act.

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Meaghan Carlson of Gardiner at her office Thursday.

Staff photo by Andy Molloy

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Jack Leet, of Farmingdale, talks about health insurance during an interview on Thursday in Farmingdale.

Staff photo by Joe Phelan

Additional Photos Below

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The multi-million dollar ad campaigns and rhetoric from politicians that's been inescapable in recent weeks?

Personal experience is glad to meet you.

Starting Tuesday, the uninsured and underinsured can begin buying discounted insurance and judge for themselves the merits of President Barack Obama's signature domestic policy achievement, signed into law three years ago.

While there's a wide range of options and prices that consumers will pay — based on income, age, subsidies and family size — a typical out-of-pocket cost for individual insurance premiums including subsidies would be about $150 per month for a mid-level plan, according to state and federal figures released in the last few months. The subsidies kick in for those earning between 100 and 400 percent of the federal poverty level.

The Maine Sunday Telegram and Kennebec Journal talked to four families interested in buying insurance on the marketplace, including a couple in Gardiner whose part-time jobs put them over the MaineCare limit, a single 27-year-old from Farmingdale no longer eligible to be covered under his parents' plan, a single mom from Portland and a newly married Falmouth couple.

How those personal interactions play out, experts say, may trump the ad campaigns, 21-hour talk-a-thons on the Senate floor, television news pundits and YouTube videos.

"A lot of people in Maine who have never been able to buy insurance will be able to, and that is going to make a difference for a lot to people," said Dora Anne Mills, vice president of clinical affairs at the University of New England and Maine's former State Health Officer.

Obama, in a speech touting the law on Thursday in Northern Virginia, predicted that people will find the insurance beneficial once they try it themselves.

"Even if you didn't vote for me, I'll bet you'll sign up for that health care plan," Obama said.

Saturday, House Republicans demanded a one-year delay in enacting the health care law and said they'd pass legislation enacting that delay by the end of teh day as the battle over how to avert a government shutdown Tuesday wages. There was no update by press time.

In Maine, the fight has mostly centered on whether to expand Medicaid, with Gov. Paul LePage vetoing efforts by the Democrat-led Legislature to do so. The Medicaid expansion, called MaineCare in the state, is another cornerstone of the ACA, but the U.S. Supreme Court ruled that states could opt out, and many states with Republican governors did so.

LePage also declined to sign up for a state-operated health insurance marketplace, defaulting that job to the federal government.

State-run marketplaces were eligible for millions in federal marketing money, used to create slick ad campaigns to encourage customers, especially healthy young people, to buy insurance.

But states like Maine that defaulted to the federal government could not tap into those advertising resources, and Mills said because of that most of Maine's outreach efforts will start after Tuesday, when people can sign up for the coverage.

Mills said while she believes the law improves the health care system, it's unknown how the law will be received, or how many people will sign up.

"It's just like asking how the Red Sox are going to do in March. Call me back in October," Mills said.

In Maine, the Bureau of Insurance has estimated that 5 to 8 percent of the population, or 65,000 to 104,000 people, will sign up for 2014 benefits.

Mills said the complexity of the law has made it difficult for people to figure out whether the ACA is good or bad until they start shopping for the insurance on Tuesday.

(Continued on page 2)

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Additional Photos

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Artist Adria Moynihan Rusk and her husband, Bruce Rusk, are a middle-class family but haven’t had good health insurance for years.

Maine Sunday Telegram photo by John Ewing

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Erika Burkhart and her 18-month-old daughter, Lumi Stone, spend time together in their Portland home.

Maine Sunday Telegram photo by Amelia Kunhardt

 


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