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Maine Non-Profit Gears up to Join ACA Health Insurance Market
05/30/2013   Reported By: Patty B. Wight

On Oct. 1, the Health Insurance Marketplace will officially open across the U.S. and in Maine. It's a component of the federal Affordable Care Act that creates an online site that allows consumers to shop and compare different insurance plans. One non-profit organization that will offer new health insurance options celebrated its grand opening today in Lewiston. Patty Wight reports.

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A crowd of supporters, including representatives from Maine's congressional delegation, today celebrated a ribbon cutting at the offices for Maine Community Health Options, a health insurance co-op.

Barbara Leonard of the Maine Health Access Foundation, which provided funding for the co-op, says there's a lot more to be excited about than just a new space. "This ribbon cutting is also a celebration of access to a new type of insurance coverage that's Maine-grown, Maine-directed, and Maine-specific."

Maine Community Health Options, or MCHO, is a non-profit whose policy holders also govern the organization. It's one of 24 federally-funded co-ops across the U.S., and as such, is expected to innovate the way it delivers health care and insurance benefits.

Kevin LewisCEO Kevin Lewis (left) says a hallmark of MCHO is that it goes a step beyond some of the base requirements of the Affordable Care Act that reward certain preventative care. "We're investing in another layer of what we consider value-based insurance benefits that are critical to long-term health," he says.

Those value-based benefits include ensuring that people with chronic conditions, such as diabetes, can visit their primary care doctor regularly to avoid both a medical, and financial, crisis. Lewis says MCHO will provide insurance to people across the state, and plans to enroll 15,000 people the first year. He says at least 30,000 will be required to keep the operation viable.

Those earning between 100 and 400 percent of the poverty level are eligible for subsidies and cost-sharing reductions. Enrollees will likely be the uninsured, under-insured, and small businesses.

"My name is David Shipman. I'm a board member of MCHO. I work at Fedco Seeds. I'm on the board of the Maine Organic Farmers and Gardener's Association, and I'm one of Maine's many uninsured."

Shipman says many employees at Fedco Seeds, a seasonal mail-order company, as well as farmers who are members of MOFGA, can't afford health insurance. He thinks Maine Community Health Options will finally provide these individuals with a viable option, even if the details of what they will get are still unclear at this point.

"I don't know it's really going to be better, but I do know the people who are working on it - their interests are different," he says. "It's not a question of. 'How much money can we make? What can we do to pare things down to return an investment?' There are no investors. There's just the people themselves. So, I think that's a help."

Part of the reason that it's still not clear what Maine Community Health Options will be able to offer is that rates are currently under state and federal review, says CEO Kevin Lewis.

"I can say that we've worked really hard to deliver on rates that will be competitive, and really offer people a choice when they look at the range of options that they can choose from on the Maine Health Insurance Marketplace," Lewis says.

The only other product that will be offered on the Maine Marketplace will come from a partnership between Anthem Blue Cross and Blue Shield and MaineHealth, which operates Maine Medical Center in Portland. Phone calls to Anthem and MaineHealth were not returned by airtime.

Photo: Patty Wight


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