Questions and Answers About LD 1784

1 Q: Where does the money come from?

A: Initial start-up funds including funding for the initial actuarial/marketing study, will be obtained by borrowing from the Maine Rx trust fund, just as was done to provide the funds necessary to implement the Healthy Maine Prescription program.

Any necessary capitalization could come from a variety of sources:

  1. Moral obligation bonding
  2. Allow the board to acquire a line of credit pledging the assets and revenues of the board (the actuarial information, etc…) as security.
  3. Another option is to exempt the product from Maine’s capitalization requirements.

Any borrowing would be repaid in a period less then ten years through a surcharge on contributions.

2 Q: What protections are there for Maine’s health care providers, doctors, hospitals, osteopaths, chiropractors, and others?

A: The board will negotiate reimbursement rates with providers that control costs, provide access, and realistically address the costs of providing health care in Maine. Providers are assured of receiving a rate of reimbursement that will allow them to do business, one that is at least as high as current Medicaid reimbursement, likely much greater.

3 Q: How does this strengthen Maine’s insurance market?

A: LD 1784 re-injects competition into Maine’s small group market. Multiple insurance carriers are able to bid for different parts of the plan or even for different regions of the state if the board chooses to allow it. Carriers have long said that if they had access to a fixed fee-schedule they could provide a competitive product for Maine people. This bill gives them that opportunity.

4 Q: Who makes up the board?

A: Appointed by the Speaker of the House, the President of the Senate, and the Governor, the board is composed of seven voting members:

  • A representative of Maine’s health care providers
  • A representative of the self-employed
  • A representative of organized labor
  • A representative of small businesses in Maine
  • A representative of health care consumers in Maine
  • A member who is a health policy expert in both the public and private health sectors
  • A member who represents low income Maine people
  • The Commissioner of Human Services will serve as a non-voting ex officio member

Changes to the board to address the concerns of other interest groups should strive to maintain balance and facilitate decision-making.

5 Q: What is a small business?

A: A small business is one with 50 or fewer workers including self-employed individuals.

6 Q: How many people will this cover?

A: While it is impossible to say for certain how many small businesses and workers will benefit from this plan without completing an actuarial study, we do know that 17% of Maine adults are uninsured, 71% of which are employed full or part time. Another segment of the population is underinsured. Maine’s underinsured are paying for health insurance but are not getting the preventative care that makes health insurance worthwhile and saves money and lives.

96% of Maine businesses are small businesses and 49% of Maine’s workforce is employed by a small business.

7 Q: How much will this plan save?

A: Again, while it is impossible to be certain what the savings to Maine workers and small businesses will be without accurate actuarial data, we believe that significant savings can be achieved by drawing down federal dollars to Maine and working together. This is the first time Maine will be using federal dollars in this innovative way.

8 Q: Where did this idea come from?

A: Working with a diverse set of interest groups, state and national experts, the Speaker and other members of leadership have taken the best elements of the work done in different states including Massachusetts and Rhode Island.

9 Q: Is this “Single-Payer”?

A: This is not single-payer. LD 1784 works to create a public-private partnership to strengthen Maine’s insurance market and provide affordable coverage to more Maine people.