Monday, March 17, 2014
AUGUSTA -- House Republicans are poised to vote today on a bill that would overhaul the state's health care system, despite critics' objections that GOP leaders are moving too quickly. Republicans presented a new version Wednesday that attempted to address some of the criticisms.
The bill would strip away state regulations and mandates that were put in place over the past two decades and open up the individual and small group insurance market to more competition.
Groups representing doctors, community health centers and consumer advocates, though, say the bill is moving too fast, leaving them with little time to understand its potential impact or even get feedback from their members.
Gordon Smith, a lobbyist for the Maine Medical Association, which represents 3,500 doctors, said that Republicans appear ready to pass the bill without any Democratic support -- a strategy that has become common in Congress but is rare in Augusta for legislation that is this significant.
Although Republicans may succeed politically in the short term, he said, they are taking a long-term risk.
"It has not been done in a responsible manner," he said of the legislation. "It will confuse the heck out of consumers, providers and the insurers themselves. It will be a lawyer's dream."
But Rep. Jonathan McKane, R-Newcastle, a member of the Insurance and Financial Services Committee, said that lawmakers are familiar with the concepts behind the bill because similar legislation has been submitted year after year and rejected by the Democratic majority.
"There is no sense to delay," he said. "The sooner we get this going the better."
Sen. Rodney Whittemore, R-Skowhegan, the House chair of the committee, said the bill is important to the 130,000 to 140,000 Mainers who don't have health insurance because they can't afford it.
"This has been a long time coming," he said. "It's nothing new."
The bill would change the rules that limit how much insurers can vary what they charge for insurance based on the age, occupation and place of residence.
Current law limits the range that insurance companies can charge between the lowest-risk policyholder and the highest-risk policyholder to a ratio of 1.5 to 1.
The GOP bill would expand the ratio next year to 3 to 1 and by 2015 to 5 to 1, meaning the highest-risk policyholders could be charged five times more than the lowest-risk policy holders.
Sen. Sharon Treat, D-Hallowell, the lead Democrat on the Insurance and Financial Services Committee, said that older, rural residents will see their insurance rates increase substantially.
However, McKane said that he's convinced that even older policyholders will see their rates go down compared to what they pay today.
He said the current restrictions have increased the costs of insurance for all groups because many young and healthy people have decided to forgo insurance. Because the people who buy insurance now are older and sicker than the general population, their insurance costs are much higher, he said.
One issue is what to do about people who have pre-existing conditions or chronic illnesses.
When the committee approved the bill last Friday in a party-line vote, the bill essentially created a high-risk insurance pool for those people. They would given the option of five insurance plans. To keep out-of-pocket premium costs the same as everyone else's, a newly created nonprofit would pick up the additional costs by taxing the premiums paid by everyone else, with a maximum tax of $4 per month per person.
Democrats objected to the idea of segregating that population into separate plans.
On Wednesday, the committee was handed a revised bill that removed that provision.
The revised bill would still create a new nonprofit that would subsidize insurance for the high-risk population using the $4 fee on insurance premiums. But in the new version, people with preexisting conditions would have the same insurance options as everyone else, and they wouldn't even know they their insurance is being subsidized.
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