Governor Mills Announces Maine Will Pursue a State-based Health Insurance Marketplace under the ACA


Governor Janet T. Mills, Addresses the Crowd at the Bicentennial Launch, Portland, Recently.

State Commissioner of the Maine DHHS in Portland at the Expo Earlier This Summer.  Previously She Served in the Obama Administration.

During a health care forum today in South Portland, Governor Janet T. Mills, the first women governor for the State of Maine, announced that Maine will pursue a State-based Health Insurance Marketplace that improves the state’s ability to fund education and outreach while using the federal website to enroll consumers in private health insurance under the ACA.

Governor Mills submitted a letter of interest today to the US Centers for Medicare and Medicaid Services (CMS) indicating that Maine will pursue this option for the 2021 health insurance plan year.  She expects to introduce legislation to establish the details of the new state-based marketplace when the legislature reconvenes in January and will be assessing additional options to make health insurance for small businesses more affordable.

“Over the past eight months my Administration has expanded health care to more than 36,000 people across the state.  There are folks who can now see doctors, receive preventive care, treat illnesses and afford their medications.  Although I am pleased with the progress we have made, there is more we can – and must do – to make affordable health care available to more people” said Governor Mills. “By pursuing a state-based marketplace, we will be putting ourselves not the federal government – in the driver’s seat when it comes to helping consumers and small employees understand the options for affordable coverage, and we will better insulae ourselves from the attacks on health care that are coming out of Washington.”

“Other states that have pursued this model have performed better on both enrollment and the cost of monthly premiums,” said Health & Human Services Commissioner Jeanne Lambrew.  “This move will allow us to customize our outreach to the communities and small businesses we know need access to health care, but who are hard to reach.”

Under the ACA, states can choose one of three options for their Health Insurance Marketplace, which consumers and small businesses use to shop for plans and apply for financial assistance for coverage.  One currently relies on the federal government to fully run its Health Insurance Marketplace.  Under the model announced today, Maine will have greater control over outreach, marketing and consumer assistance initiatives, which he federal government will continue to provide its call center and where consumers can apply for and enroll in coverage.  The Mills Administration is also exploring the possibility of transitioning from this model to the third option, a fully state-run marketplace in the future.

Under this approach, the Maine Bureau of Insurance would still oversee the individual and fully-insured group markets.  It would continue “plan management” – or engagement with insurance carriers in the Health plan offerings.

If Legislation passes to create a State-based Marketplace using the Federal Platform, then Maine will submit a plan to CMS for for approval.  DHHS can manage the cost of this activity with some of the additional federal funding that will result from Maine assuming control over its Marketplace’s outreach and education,.

The decision announced today will not affect the upcoming open enrollment period in November 2019 which will proceed in the same way as previous open enrollment periods.  Still, DHHS will work with community partners to increase awareness and promote shopping for plans that meet the needs of Maine families and businesses.

The Governor announced he decision today at All In:  A Forum on Health Care Coverage and Affordability in Maine, an event held at the Maine Department of Health and Human Services (DHHS) regional office in South Portland,.