September 29, 2013

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

By Joe Lawlor
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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Evan McSwain, a cook at Selah Tea in downtown Waterville, has been uninsured for the last five years.

Staff photo by Michael G. Seamans

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Meaghan Carlson, of Gardiner, at her office Thursday.

Staff photo by Andy Molloy

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Waterville Public Library will host information sessions for residents seeking information about the Affordable Health Care Act at 2 and 5 p.m. Tuesday.

The multimillion-dollar ad campaigns and rhetoric from politicians that have 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 percent and 400 percent of the federal poverty level.

The Maine Sunday Telegram, Morning Sentinel and Kennebec Journal talked to four people interested in buying health insurance on the marketplace: a single Waterville man who hasn't had insurance in five years, a couple in Gardiner whose part-time jobs put them over the MaineCare limit, a single mother 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 the day as the battle about how to avert a government shutdown Tuesday wages. There was no update by press time.

In Maine, the fight has centered mostly 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, leaving 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.

However, states such as Maine that left that job 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 actually 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 percent to 8 percent of the population, or 65,000 to 104,000 people, will sign up for 2014 benefits.

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

(Continued on page 2)

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Additional Photos

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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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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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