With the long-awaited U.S. Supreme Court decision on the federal health care law behind us, Maine should resume laying the groundwork for the next step required under the law: health insurance exchanges.
That, however, will require Gov. Paul LePage to put aside his aversion to the new law and make sure Maine is ready to meet important deadlines.
The exchanges could provide a free-market solution to health care affordability in Maine.
To be clear, Maine has a relatively low percentage of uninsured residents, about 14 percent of those between 19 and 64 in 2010, according to the Kaiser Family Foundation. In Texas, the rate for the same age bracket is 33 percent, while the U.S. average is 22 percent.
Still, in Maine, that leaves well over 100,000 people between 19 and 64 without health insurance.
Research shows that people without health insurance are 40 percent more likely to die than those who have it. They wait longer to receive care and medical problems are more often detected when they are difficult or impossible to successfully treat.
Even when life-threatening problems are detected, those without health insurance are more likely to receive spotty or inconsistent care.
Estimates vary, but as many as 45,000 people die each year from problems that would have been detected and successfully treated if they had health care insurance.
The health insurance exchanges will provide a searchable marketplace for health insurance.
Companies will compete to provide policies to individuals and small businesses. Families with incomes between 133 percent and 400 percent of the federal poverty level will receive federal income tax subsidies to make the insurance more affordable.
But there is a deadline. By Nov. 16, states must tell the federal government whether they plan to set up their own exchanges by Jan. 1, 2014.
If states decide not to set up exchanges, the federal government will set them up for them.
Maine was well on the way to using federal grants to meet the exchange requirements until Republicans came to power in Augusta.
Gov. Paul LePage stopped the preparatory work as the state’s attorney general joined other states asking the Supreme Court to declare the law unconstitutional.
That effort failed last week when a majority of justices found the most controversial provision of the law, a mandate to obtain health insurance, constitutional.
Some states are now arguing that they will not plan for the new law hoping for two results in the November elections: A Republican president and a Republican majority.
With deadlines looming, Maine should proceed with planning rather than take that gamble, especially since the federal government seems willing to invest even more in the planning process.
Maine could then be ready with a coherent, workable plan that moves more Mainers out of limbo and into a health insurance plan.
rrhoades@sunjournal.com
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