By Ramona du Houx
A bipartisan measure to protect the tax credits that help more than 66,500 Mainers afford their health insurance won strong support at its public hearing Thursday.
LD 1344, sponsored by Rep. Linda Sanborn, D-Gorham, safeguards the tax credits that are used by 89 percent of Mainers who get their coverage through the health insurance marketplace. The fate of the Advance Premium Tax Credits is in question because of a pending U.S. Supreme Court case.
“We know that 66,576 Mainers have the security of health care coverage thanks to these tax credits. Without these subsidies, they are in danger of losing access to life-changing health care,” said Sanborn, a retired family physician who served on the Health Exchange Advisory Commission. “It’s likely that the Supreme Court case won’t be resolved before the Legislature adjourns. It’s critical that we act now to prevent chaos and have a plan in place for consumers.”
If the Supreme Court decides in the King v. Burwell case that federally facilitated marketplaces cannot offer the tax credits to consumers, health insurance on the exchange will be out of reach to consumers in Maine, where the average subsidy is $332.
Sanborn’s bill establishes a state-run exchange for Maine if the federal government notifies the state that the tax credits will be unavailable through its federally facilitated marketplace. Under the Affordable Care Act, states could run their own marketplaces, also called exchanges, or have a federally facilitated one. Maine had opted for a federally facilitated marketplace.
According to the U.S. Department of Health and Human Services, 74,805 Mainers had a health insurance plan for 2015 through the federally facilitated marketplace, with 89 percent – or 66,576 individuals – making use of the tax credits.
The credits are available to those making between 100 and 400 percent of the federal poverty level. For a household of four, 100 percent of the federal poverty level is $23,850 and 400 percent is $95,400.
Alyce Ornella of Harpswell told the committee how much her family relies on the tax credits. She and her husband are self-employed and could not afford the expensive premiums for private insurance. They were, however, able to sign up for coverage on the exchange because of the tax credit before their son’s birth.
He seemed healthy for the first hours after his birth, but his condition rapidly deteriorated to the point that he needed emergency transport to the neonatal intensive care unit at Maine Medical Center. He had a series of rare congenital defects, the most pressing being that his esophagus was not connected to his stomach, which was causing him to suffocate on his own saliva.
“Sam has received outstanding care from these talented local doctors. In the course of that care, however, his medical bills topped $100,000 during his first month of life. He will need specialized care through childhood and possibly as an adult,” Ornella testified. “We never expected such financially devastating medical costs. Thankfully, our baby is doing well precisely because we were finally able to get insurance through the ACA and premium tax credits. Our family is not shackled by hundreds of thousands of dollars in medical bills and our child will not go without treatment he needs.”
The Maine State Chamber of Commerce supports the bill, stressing the need for state government to have a plan.
“Coverage for individuals and sole proprietors has been made affordable due to the availability of subsidies. Some of those individuals may have even become sole proprietors, daring to venture out into the business world to start their own businesses due to the affordability of their health care insurance,” Peter Gore, the chamber’s vice president for advocacy and governmental relations, said in his testimony. “If coverage becomes unaffordable that leaves individuals with little choice but to drop their health insurance policies. That’s bad for the individuals, but it’s also bad for our economy and the overall cost of health insurance in this state.”
Rep. Karen Vachon, R-Scarborough, a cosponsor of the bill, provided her perspective as an insurance agent who has seen the positive impact that the exchange has had on premium costs.
“The APTC has assisted tens of thousands of families and small business owners gain access to affordable health insurance – ensuring quality health care and better peace of mind,” she testified.
The bill is also cosponsored by Rep. Henry Beck, D-Waterville, Rep. Janice Cooper, D-Yarmouth, Rep. Robert Foley, R-Wells, Sen. Geoff Gratwick, D-Bangor, Sen. Roger Katz, R-Augusta, Rep. Matt Pouliot, R-Augusta, and Sen. Amy Volk, R- Scarborough.