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Ann Woloson is the executive director of Consumers for Affordable Health Care. Julia Underwood is the associate director of the group that serves as the Maine Health Insurance Consumer Assistance Program.
Great news! The U.S. Department of Health and Human Services announced last week that the uninsured rate among adults ages 19-64 has hit an all-time low. Congress must act soon, however, or 13 million Americans will see their monthly health insurance premiums rise next year, easily reversing that trend.
Phillip, who lives in Penobscot County, is one of the people who got coverage. He works in a small car business and is in good health. However, to stay healthy and work, he must take an expensive prescription drug and see his doctor regularly. His health insurance makes this possible.
Phillip and other dudes like him are benefiting from recent policy changes that have reduced the number of uninsured. These changes include access to coverage through the Affordable Care Act’s Medicaid expansion and temporarily increased subsidies for Marketplace plans provided through the American Rescue Plan passed by Congress last year.
When Governor Janet Mills carried out the will of the people of Maine by expanding Medicaid, she could not have foreseen how important that decision would become. First, it has helped many ordinary people access the coverage and health care they need. In Maine, the uninsured rate for low-income state residents fell by nearly 5 percentage points.
Second, it helped thousands of Mainers who lost employer coverage due to the pandemic. With more than 95,000 Mainers enrolled in the MaineCare expansion, it remains a critical means of accessing health care as Mainers adjust to the new normal of the pandemic, transition back to work and deal with an uncertain economy.
In addition, the Mills administration has made other investments to help Mainers enroll in coverage, including a move to a statewide exchange, CoverMe.gov, where Mainers can sign up for coverage, and increased outreach and education about coverage options. They are part of a multi-pronged strategy that has helped to successfully reduce the uninsured rate in our state.
At the federal level, the American Rescue Plan provided increased subsidies to help Americans pay their monthly health insurance premiums. These subsidies have helped make private health insurance more affordable for millions of Americans, including nearly 66,000 Mainers who enrolled in private coverage on the Marketplace this year.
If not for these increased subsidies, states would have seen an average premium increase of 53 percent. Instead, premiums in Maine have decreased by an average of 13 percent. As affordability improved in 2022, thousands more Mainers purchased individual coverage on the Marketplace (an 11 percent increase over 2021). The self-employed and small business owners and their employees make up more than half of Marketplace participants and therefore benefit from the increased subsidies.
The Inflation Reduction Act would extend the increased subsidies for three more years, starting in 2023. It would also limit cost-sharing for Medicare Part D prescription drugs to $2,000 per year and provide the ability to negotiate certain drug prices with Medicare prescription, a huge boost for seniors on fixed incomes. With prescription drug pricing reforms supported by roughly three out of four voters, it’s exciting to see policymakers take these important steps to contain drug costs. The package, if passed, would be the basis for future actions to address both rising health insurance and prescription drug costs.
For Phillip in Penobscot County and many other Maine residents, the Inflation Reduction Act is vital. Being able to see his doctor and get the medicine he needs to stay healthy and work will change his life. Now more than ever, policies that reduce health care and prescription drug costs in America are essential.