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Ann Woloson is the executive director for Consumers for Affordable Health Care. Julia Underwood is the associate director of the group, which serves as Maine’s Health Insurance Consumer Assistance Program.
Great news! The US Department of Health and Human Services announced last week that the nation’s uninsured rate among adults, age 19-64, has reached an all-time low. However, Congress must act soon 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 gained coverage. He works for a small automotive business and is in good health. However, to stay healthy and work he needs to take an expensive prescription drug and see his doctor regularly. His health insurance makes that possible.
Philip and other Mainers like him benefit from recent policy changes that reduced the number of uninsured. Those changes include access to coverage through the Affordable Care Act’s Medicaid expansion and temporarily increased subsidies for Marketplace plans made available through the American Rescue Plan, passed by Congress last year.
When Gov. Janet Mills implemented the will of Maine people by expanding Medicaid, she could not have foreseen how vital that decision would become. First, it helped many everyday people access the coverage and health care they need. In Maine, the uninsured rate for the state’s low-income residents decreased nearly 5 percentage points.
Second, it helped thousands of Mainers who lost employer-based coverage due to the pandemic. With over 95,000 Mainers enrolled in MaineCare expansion, it remains a critical means to access health care as Mainers adjust to the new normal of the pandemic, transition back to work, and deal with the uncertain economy.
In addition, the Mills administration has made other investments to help Mainers enroll in coverage, including transitioning to a state-based exchange, CoverMe.gov, where Mainers can sign up for coverage and increased outreach and education about coverage options. These are part of a multi-faceted 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 helped make private health insurance more affordable for millions of Americans, including nearly 66,000 Mainers who were enrolled in private Marketplace coverage this year.
If not for those enhanced subsidies, states would have seen a 53 percent premium increase on average. Instead, premiums in Maine decreased by an average of 13 percent. As affordability improved in 2022, thousands more Mainers purchased individual Marketplace coverage (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 consequently benefit from the increased subsidies.
The Inflation Reduction Act would extend the increased subsidies another three years, starting in 2023. It would also cap prescription drug cost sharing under Medicare Part D to $2,000 annually and provide an opening for negotiating certain prescription drug prices under Medicare, an enormous boost to seniors on fixed incomes. With prescription drug pricing reforms having the support of roughly three in four voters, it is exciting to see policy makers taking these important steps to kidney in drug costs. The package, if passed, would be a foundation for future action to address both rising health insurance and prescription drug costs.
For Phillip in Penobscot County and many other Mainers, the Inflation Reduction Act is vital. Being able to see his doctor and get the medicine he needs to stay healthy and work will make all the difference in his life. Now, more than ever, policies that reduce the cost of health care and prescription drugs in America are essential.
