Health Reform is Making History – But Maine is Slipping Behind

September 22, 2014 by

History is happening: the percent of Americans without health coverage is the lowest it’s been since the 1990s. Medicare costs are declining – not just slowing – making the program more sustainable in the future. Maine’s 2015 marketplace premiums are either flat – or lower than last year. Health reform is working.

I happened across a time capsule this summer, and it brought home for me exactly how huge an impact the Affordable Care Act (ACA) has had. As all Mainers know, there are camps and cottages across our state, and they usually have stacks of old copies of National Geographic, paperbacks from the 1970s, and other remainders from past visitors. My family camp is no exception. Someone had folded a Bangor Daily News op-ed page from July 2007 and stuffed it neatly in our magazine rack. Taking it out, I read the first editorial, which bemoaned the intractable rise in health costs with no end in sight. The writer said, “The best way to take on the rising cost of healthcare would be national, wide-scale health reform – but that looks unlikely to happen any time in the near future.”

What a difference seven years makes. Health reform did happen within two years of that editorial, and that dour editorialist could never have foreseen what the results have been:

The uninsured rate has declined significantly – and most significantly for young adults.

Overall, the uninsured rate declined from 2013 to early 2014. The most significant decrease was among young adults aged 19-25. In 2013, 26.5 percent of young adults were uninsured; by the first three months of 2014, that number had dropped to 20 percent. This is partly attributable to the ACA’s popular provision that allows parents to keep their college-age children on their policies, and partly a function of the insurance exchanges, which experienced an uptick in young adult enrollment toward the end of the enrollment period.

Medicare costs per-user are down – and not due to roughshod cuts or privatization.

As the baby boom generation ages, Medicare costs have strained the federal budget. It’s worth recalling that opponents of the ACA have their own proposal to reduce federal Medicare costs: end Medicare as we know it in favor of a privatized voucher system. That hasn’t come to pass, but in the meantime, the successful aspects of the ACA have lowered Medicare costs by eliminating fraud and waste and coordinating patient care. Three years ago, Medicare spent $12,000 per person. Now it spends $11,200, and analysts project that cost will keep declining. The 10-year savings connected to this trend amount to $715 billion – making the ACA’s Medicare reforms a champion among deficit-reduction initiatives.

Despite opponents’ dire predictions, enrollment in marketplace plans exceeded expectations.

Despite predictions that the plans would be too expensive, that the uninsured did not want to buy health insurance, and that the unwieldy website would doom the ACA marketplace, people flocked to sign up for coverage in the last months of the enrollment period. In the end, more than seven million people purchased insurance through the marketplace. Twenty-two states exceeded their enrollment goals – some by more than 160 percent.

And (again despite naysayers’ predictions), 2015 marketplace premiums did not skyrocket.

Once marketplace enrollment was declared a success, the naysayers rolled out a new gremlin from their stockpile of bogeymen. “Get ready for your 2015 Obamacare premiums to double or even triple,” they warned.

2015 rates have not tripled. In Maine, average marketplace premiums will either decrease or remain flat. While premiums vary by state, few exceed double-digit increases – and remember that insurers can no longer charge healthy people less and sick people more, as they did in the bad old days. One of the scariest cases was self-inflicted: one insurer in Florida announced a 17.5 percent hike – but this was due to the concerted effort of ACA opponent Governor Rick Scott, who suspended the legislature’s ability to veto excessive insurance premium hikes.

Will Maine move into the future – or remain trapped in a pre-ACA time capsule?

In a state economy that has struggled with high health costs, this week’s rate announcement is welcome news.  Up to) 44,000 Mainers now receive coverage through the marketplace. Health reform works for Maine – when policymakers let it. Maine’s continued refusal to accepting federal healthcare funds, combined with 2011 cuts to MaineCare, means that our state is moving backward, not forward. Maine and New Jersey are the only two states where the rate of uninsured increased over 2012-2013. This is a bitter pill to swallow, especially when historically, Maine’s uninsured rate has been among the nation’s lowest.  Health reform has happened, and it’s providing savings and opportunities that were inconceivable as recently as 2007. Let’s not keep Maine stuck in reverse, but start moving in the right direction again.

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