AUGUSTA – Today The Health Exchange Advisory Committee unanimously endorsed a set of recommendations to help Maine people obtain affordable health care available through the health insurance marketplace.

“Our diverse group agreed on how the state can make a difference for Maine people and businesses that need affordable health care,” said Rep. Sharon Anglin Treat, D-Hallowell, House chair of the committee. “Closing the coverage gap as soon as possible will make the exchange work better not only for uninsured Mainers but for medical providers and insurance carriers as well.”

A significant portion of individuals seeking insurance on the marketplace fall into the coverage gap, meaning they earn too much money to qualify for MaineCare but will not be eligible for subsidies on the marketplace, according to testimony from representatives of federally qualified health centers that enhance primary care for underserved communities, navigators and certified application counselors.

The committee was unanimous in believing that closing the coverage gap by providing affordable coverage as soon as possible would improve the marketplace, not only for individuals but for insurance companies and medical providers.

Also of note are the committee’s recommendations on outreach. The committee found that the technical challenges with the federal website and the state’s large size warrant additional outreach efforts, especially to small businesses.

The first of the outreach recommendations asks the administration to develop a grant proposal by May, 15, 2014 for additional federal resources to enhance consumer education, outreach and assistance. Federal grants are available to train individuals to be unpaid navigators and reach out to businesses.

The second recommendation seeks the continuation and expansion of the navigator program through federal funding. At this time, Western Maine Community Action and the Maine Lobstermen’s Association/Fishing Partnership Health Plan have been awarded federal funds to serve as navigator entities for 2014 only. Some areas of the state have no navigators.

The committee’s report, which will be presented to the Legislature’s Insurance and Financial Services Committee by Dec. 15, also addresses transparency on rating factors, the effectiveness of the federal marketplace for the state, state information on health coverage options and data collection and reporting.

“It was important for us to reach consensus on how to improve the marketplace. We worked hard to clarify the issues and move us closer to getting affordable health care for Mainers,” said Sen. Margaret Craven, D-Lewiston, Senate chair of the committee.

Other recommendations endorsed by the committee include:

•         Supporting changes to state and federal law to increase transparency and financial certainty for employers around composite ratings, a method of determining premium levels for small groups;

•         Maintaining the federal marketplace for Maine in 2015 while continuing to gather information and evaluate its effectiveness for the state, with the goal of determining whether a different model is needed in 2016;

•         Ensuring the accuracy of communications about health coverage options from the state Department of Health and Human Services; and

•         Developing uniform criteria for entities collecting eligibility, enrollment and demographic data and regular reporting based on the data.

The committee serves as the key link between Maine people, state government and the health insurance marketplace. The committee is made up of a broad range of stakeholders. They include representatives of Medicaid recipients, health and dental insurers, health care providers, hard-to-reach populations, the general public and employers, among others.

For more information about the committee, including meeting dates and agendas, go to http://www.maine.gov/legis/opla/healthexchangeac.htm.

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