Maine news, sports, weather | Kennebec Journal, Augusta, Maine

MAINE COMPASS: National health reforms bolster Maine work

Our nation has made history.

Against all odds, and building on the work of generations that came before us, we affirmed that all of our citizens have a right to basic health security.

The health-care reform legislation signed into law by President Barack Obama will reduce the cost of health care for the middle class, ensure health security to seniors, and provide tax credits to small businesses and individuals to make health coverage affordable.

Because health-care costs are such a burden on our economy, taking these steps to expand access will reduce the federal deficit by $143 billion over the next 10 years, with further deficit reduction in the following decade, according to the independent nonpartisan Congressional Budget Office. A side benefit is the 1,300 to 2,100 jobs that will be created by reducing health-care costs for employers, according to the U.S. Public Interest Research Group.

But Mainers may wonder how the sweeping health reform will affect them.

Maine is a longtime leader reforming health care, but we have learned how challenging it is for a state on its own to achieve health insurance coverage for all.

 National reform changes that equation. The new law complements and expands Maine’s reforms and levels the playing field so that all states must enforce consumer protections Maine has pioneered. 

According to the U.S. Department of Health and Human Services, the new law will ensure affordable health coverage for 135,000 Mainers who are uninsured and 69,000 Mainers who purchase health insurance through the individual market.

The new health insurance exchanges, where Mainers will be able to shop for a variety of health insurance policies, won’t be fully operational until 2014, but some key reforms go into effect right away.

Immediately, as many as 17,750 uninsured Mainers who have a pre-existing condition won’t have to wait to get health insurance, and insurance companies won’t be able to use someone’s health status to deny coverage.

The law also addresses one of the biggest challenges for small businesses, which account for 78.7 percent of all Maine businesses. Most small business owners say the cost of health insurance can make or break their profit margins. Only 45.6 percent of these small businesses are able to offer health insurance to their employees.

Starting this year that will change.

Maine small businesses — 22,600 — with 25 or fewer employees will be eligible right away for tax credits for a percentage of their contribution to employees’ health insurance.

According to the U.S. Department of Health and Human Services, small businesses that qualify for these tax credits employ 92,600 Mainers.

This year, the law will make sure that dependent adult children up to age 26 can be kept on their parents’ individual or group policies.

Many preventive services now must be provided without copayments or deductibles, including immunizations, preventive care for infants, children and adolescents, and additional preventive care and screenings for women.

Seniors will get financial help to pay for their prescription drugs.

Employers providing health insurance coverage to retirees over age 55 who are not eligible for Medicare will benefit this year from a reinsurance fund. Reinsurance will reduce the cost of insurance policies for these retirees, who otherwise tend to drive costs upward simply because they are older and have more health problems. This program will be phased out in 2014 as other reforms are implemented.

Insurance companies will have to spend more of the premium dollars they collect from consumers and employers to actually pay for health care — and less on profits and administration.

Although Maine already has rules in this area, the new law goes further, and starting in January, insurers who don’t meet these standards must pay rebates to consumers.

Now that federal reform has passed, we are ready to make sure that it is implemented effectively so that Maine people and businesses can take maximum advantage of its provisions.

The Maine Legislature, in a unanimous, bipartisan vote, has supported forming a legislative task force to meet over the summer and fall to make sure that Maine gets a head start implementing these reforms.

We know our active collaboration with the federal government will ensure we have a seamless transition that retains the best of what already works well for Maine people, while making health care more accessible and affordable for all.

Rep. Sharon Treat, D-Hallowell, is House co-chairwoman of the Legislature’s Insurance and Financial Services Committee. Rep. Patsy Crockett, D-Augusta, serves on the Taxation Committee.