AUGUSTA – Speaker Sara Gideon today presented a LD 2007, “An Act To Enact the Made for Maine Health Coverage Act and Improve Health Choices in Maine,” before the Legislature’s Committee on Health Coverage, Insurance and Financial Services. LD 2007 was introduced by Speaker Gideon on behalf of Governor Janet Mills.

“Not a single Mainer should be rationing their medication or avoiding a trip to the doctor because they aren’t sure what it will end up costing – every single one of us deserves access to quality, affordable health care. With ongoing uncertainty at the federal level, it’s critical that we craft lasting state policies that ensure stability and predictability for consumers here in Maine,” said Speaker Sara Gideon. “This legislation will help control out-of-pocket costs, bring stability to the volatile small business marketplace, and make shopping for health insurance simpler and easier. This session we must address these urgent matters, and I look forward to continuing our partnership with Governor Mills to ensure prescription drugs are affordable, healthcare – including reproductive care – is accessible, and opioid recovery services are available throughout the state.”

Speaker Gideon’s submitted written testimony is below.

Senator Sanborn, Representative Tepler and distinguished members of the Joint Standing Committee on Health Care Insurance and Financial Services, thank you for welcoming me today.  I am Sara Gideon, from Freeport and the Speaker of the House of Representatives. I’m here today to speak in favor of LD 2007 – An Act To Enact the Made for Maine Health Coverage Act and Improve Health Choices in Maine.

No matter what district you represent, the challenges faced by Mainers when it comes to affording and accessing adequate healthcare are staggering. Whether it be an unaffordable deductible, a two hour or more drive to see a specialist, an unexpected diagnosis or an emergency room visit, too many of us are one step away from an impossible situation. 

That is exactly why we began our second session with a renewed focus and a renewed commitment to the health and well-being of Mainers, specifically access to affordable, quality health care. As members of this committee are well aware, this issue is one of the biggest drivers of whether or not you can live your life to the fullest, whether or not you can grow your business, whether or not you can get to work, and something that in the blink of an eye can change your entire life.

LD 2007 is a smart, targeted approach to improve health insurance for Maine people and small businesses. With ongoing uncertainty at the federal level, it is critical that we craft lasting state policies like LD 2007 that ensure predictability for consumers here in Maine. This legislation will help consumers control out-of-pocket costs and compare plans, bring stability to the volatile small business marketplace, and make shopping for health insurance simpler and easier.

To help control costs, the legislation requires health plans to cover the first primary care visit and behavioral health visit each year with no out-of-pocket cost to consumers, making some of the most common health care visits less costly. 

This bill seeks to incentivize people to see their doctors regularly and catch small problems before they become big ones. There is no replacement for building a trusting relationship with a primary care provider, someone who knows a patient’s medical history, and sometimes just getting in the door for that first appointment can make all the difference.   

We also believe it is important for people to understand what they are getting for their money and compare plans easily. This bill would create “clear choice designs” to standardize cost sharing for similar health plans. Starting in 2022, qualified health plans in each level of coverage (bronze, silver, gold and platinum) would generally have the same deductible, out-of-pocket limit, and copays for a set of commonly-used services. The dollar amounts would be developed in consultation with a working group of stakeholders including patients and providers and updated annually. We can help consumers understand deductibles and copays and make apples-to-apples comparisons of plans, while encouraging insurers to compete on premiums and quality. 

To bring stability to the volatile small business marketplace, the bill merges the small group and individual markets in Maine, creating a combined, larger and, as a result, more stable pool of enrollees to help fight unpredictable premium increases. Insurers will then be able to determine premiums based on this larger pool and offer the same plans to both individuals and small businesses, thereby helping small businesses to get a handle on health care costs. 

Finally, to make shopping for health insurance simpler and easier, we propose that Maine run a State-based Marketplace using the federal website, HealthCare.gov, and related services. Running our own Marketplace gives Maine new choices, such as extending the annual open enrollment period, customizing the outreach and website to fit Maine’s needs, providing assistance to small businesses interested in using health reimbursement arrangements, and promoting the types of health plans Mainers want.

Maine would conduct its own education, in-person consumer assistance, and outreach on coverage. Funding for the Marketplace would come from existing user fees on insurance companies, no higher than what the insurance companies pay now.

This proposal was carefully crafted to meet the concerns expressed by Mainers. It has the support of organizations such as Consumers for Affordable Health Care, Maine Equal Justice Partners, AARP, Maine Public Health Association, the American Cancer Society – Maine, Maine Medical Association and Maine Hospital Association. 

I recognize that this committee has a tremendous amount of work and I want to thank you for your dedication to creating real and lasting change for Maine consumers and businesses. I also want to thank Governor Mills and her Administration for their continued commitment to improving our healthcare systems in every corner of Maine.

I am sure there are others that will follow me today that can dive into the technical details, but I’d be pleased to answer any questions you may have. I’m confident the committee will consider these matters carefully and I respectfully ask that you support LD 2007 and swiftly move its passage.