AUGUSTA, Maine — Older Mainers living in rural areas will pay more for health insurance under a controversial bill passed last spring, while many others will see lower rates, according to a new independent report.
Most people who buy their own health insurance, particularly the young living in urban areas, will pay less for premiums as a result of the law, known as PL 90, but about 20 percent who are older and reside in areas such as Down East and northern Maine will pay more, according to a report by Gorman Actuarial of Massachusetts, a consulting firm commissioned by the state to review the law’s impacts.
The bill overhauled the health insurance market for about 40,000 people who buy coverage through the individual market or through employers with fewer than 50 workers, known as the small group market.
“Gorman Actuarial found that thousands of older Mainers and small businesses in rural Maine must now pay more for health insurance under the new law,” Garrett Martin, executive director of the left-leaning Maine Center for Economic Policy, said in a press release. “It validates MECEP’s analysis last spring which warned that while some individuals and businesses would realize lower rates, others would see their costs increase. PL 90 is a flawed law that the governor and the Legislature must act to fix.”
The law allows insurers from other New England states to sell insurance in Maine and gives them more leeway in setting rates based on age, geography and tobacco use. It also creates a high-risk pool for Maine’s sickest residents funded partially by a fee charged to nearly all private policyholders in the state.
Joel Allumbaugh, health care policy director for the conservative Maine Heritage Policy Center, called the report “largely positive.”
“The Gorman report illustrates that 84 percent of small business members benefit from PL 90 in the first year [and] 93.6 percent benefit in the second year,” he wrote in an email.
Allumbaugh also pointed out that the report predicts growth in the small group market.
“This market has been in a death spiral and PL 90 begins to reverse that trend,” he wrote.
The report includes a number of assumptions because lawmakers haven’t fully ironed out the law’s implementation.
The bill, then known as LD 1333, generated heated debate last year after Democrats accused Republicans of rushing the bill through the legislative process. Supporters argued that increased competition and other changes would lead to lower rates, especially for younger people, while opponents said the law would raise costs for older Mainers living in rural areas.
According to the Gorman report, presented Tuesday to the Legislature’s Insurance and Financial Services Committee, rates for individuals could drop 12 to 15 percent, spurring overall growth of that market. As insurers are reimbursed for high-risk individuals using subsidies from the rest of the market, premiums will drop, the report states.
Most of the future growth, however, will result from the federal Affordable Care Act, which mandates coverage for individuals, according to the report.
In the small group market, which includes many small businesses that provide health insurance for their employees, the majority will see little change in premiums. But 7 percent of small group members, generally older populations in rural areas, will see their rates go up an average of 20 percent higher than they would have without the law, the report found. Another 9 percent will see significantly lower premiums.
I’m sure the old timers will have no problem paying a little extra for their beloved governor :O
crapped on the poor of Maine/ check!
Crapped on the elderly of Maine/ Check!
Crapped on the young people of Maine/ check!
That leaves the Rich who are enjoying their tax breaks ; )
And the stupid who don’t realize they’re being crapped on : (
Yup! Maine is getting it penguin style .
You left out the small businesses of Maine. We are getting crapped on as well. Check
According to the other article I guess the hospitals are getting it too. Anyone else been crapped on by the Penguin?
The list of those not crapped on by LePage would be much shorter.
I look at it this way. With the Democrats out of power the amount of damage they can do is minimized.
Okay, so all you LePage and the Republican crew “haters”–you were all much better off before they were elected? Right? The State of Maine was in a state of harmony and bliss before the last election? Hmmm? Nobody was a little peeved that Dirigo was not covering the number of people it was projected to, but was still costing more than expected? Nobody went to ‘Gusta to protest the mandatory “time off with no pay” that state workers had to absorb, in addition to pay freezes? Nobody in the health care field complained a smidgen about the state not paying for Mainecare services and causing their hospital to have to lay off workers, freeze pay and raid other accounts?
Nobody felt disgruntled when the state not only failed to meet the 55% educational funding it had been mandated by you, the voter, to meet, but also cut the money they were sending to towns? Leaving all you happy local real estate tax payers—you know, that horribly regressive real estate tax–to pick up the tab for crumbling schools that were not receiving any state money to be fixed or replaced….oh, my, I could go on and on about those halcyon days in Maine before Paul and the Republicans came to town.
Geesh…sometimes you people act like children–you are sick and are miserable, but you won’t swallow the medicine to get better will you?
What tax breaks are you referring to?
One small step for LePage, one giant leap for Anthem and Aetna. We just need to remember, it’s all about “people before politics”. He just neglected to clarify which people I guess.
We can render him helpless in November if we vote out his buddies. I, for one, am a republican voting straight democrat in November.
I expect you would have voted Democrat anyway no matter your registration and probably always have.
Well, your expectation would be dead wrong on the always have, but dead right on will vote democrat in the next election. I know several people including State workers, retirees, and shamefully, myself that voted for this clown because we believed his campaign promises. I regret it everyday.
What is this ” Maine Heritage Policy Center”? Oh, wait a minute. Here is how they describe themselves: “The Maine Heritage Policy Center is a research and educational
organization whose mission is to formulate and promote conservative
public policies.”
Ohhhh, the Koch brothers!!! If they like the insurance system, it must benefit the insurance companies and it must stink for the rest of us.
I heard that the Maine Heritage Policy Center is getting a much better office. A bigger post office box.
They need A bigger post office box.
The Marching Orders are getting Bigger!
Why is it that you libs have such a fit about the Koch brothers, but think the destruction George Soros has wrought on virtually every economy on the planet is fine??????? He’s declared war on everything from the English sterling to the Tea Party movement, throwing billions into liberal causes, the more radical the better, all in the name of charity. I am, quite frankly, tired of the double standard.
93.6% will have a decrease in health care cost. That’s a good thing right?
that’s bs. That will never happen. Everyone I know are getting increases.
Republican politics–tax cuts for millionaires, and improve health insurance a bit for some people, while raising costs for poor rural elderly people. NOT a good thing.
Now how do they come up with that figure?? We are supposed to be the oldest state in the union and this article claims that the young urbanites will get a break in insurance costs. That is if you can get them to buy insurance. Fact is that most of the young are willing to take their chances unless they have a job that gives them coverage as part of their benefits.
Once again the poorest regions of this state get screwed. Once again the poorest citizens are being charged more. Once again the Republican/Tea/MHPC Party shows it’s true colors.
If nothing else shows the citizens of this state that we need a single payer system where all citizens of this state are covered, this is a prime example of the future vision of this state by those currently in power.
Why not let the insurance companies bid for that single provider coverage? That way we all pay our fair share of the rates.
Remember in November that he couldn’t have passed this without his “friends” in the Maine Legislature. There was less debate on this prejudicial bill than there was on whether or not to have the whoopie pie as the States official treat. What a bunch of morons.
Sad but true. This Independent is doing the same thing you are. I’ve never voted straight Democratic before…but I will be this time…just to politically neuter this nightmare of a governor and his tea-toting cronies.
The only way a single payer healthcare plan will work is to come from the federal level like every other civil country. Is it perfect no but it’s the only way to rein in the healthcare cost. It’s cost is killing the country.
Well, isn’t this nice. Get old, but don’t settle in Maine. And, if you decide to settle, be ready to line the pockets of the insurance companies. Oh, that’s right, I can go shopping for health insurance from other states. The answer there is, “Don’t keep the money within the state! Go figure?
If you buy your insurance from another state you will not be protected by insurance regulators. Which is why the insurance companies LOVE this program.
I am left wondering if the Gorman report took into account the Governor’s proposal(which has not yet become law) to eliminate income tax on pensions. If it did not, then retired people won’t be quite so bad off as Gorman predicts.
Mull that over while while the insurance death squads go after our elderly. Most cultures regard their elderly with respect not as a statistic to mess with after years of service to the country. We are a God fearing country? The God I learned about did not balance the well being of health care on those who built the foundation of our state and country. I am not left wondering, pondering,sitting back in my chair monkeying around with my profound thoughts.
We *used* to be a God-fearing country…that hasn’t been true for quite a long while. Healthcare is a human concept and invention…I don’t believe that anyone’s object of worship dictated anything directly related to healthcare and its administration.
We are not a God fearing country. We are a country based in part, on freedom of religion. That includes all religions, or even lack there of. Government is a business, which has nothing to do with religion. Business is about the amount of money coming in, and the amount going out. Nothing more. While I do not agree with LePage and his policies, I think something has to be done. This is not it. But God is not going to help our current state of affairs. No matter how many prayers.
So lets keep God out of politics. Last time God was involved in politics, one of the cabinet members turned on His son.
Maybe government should be run like a business, but it should be a “non profit” business. We are the government! Politicians are supposed to be our representatives.
there elderly, he’s throwing you a bone so that you forget about how he’s dumping on you otherwise.
I’m well aware of what he’s doing…
Are you serious? Give me a break. You’re saying retired people will be slightly less worse off (if the law even passes).
I was only questioning whether the Gorman report took into account proposed changes that the Governor has made, and if Gorman hasn’t, retired people would not end up quite as badly as the 20-30 percent increase that they expect for rural/retirees. No mistake, insurance premiums will increase in any case.
It also probably didn’t anticipate the booting of 65,000 Mainers off Mainecare, thereby raising the cost for the old folks even more.
Insurance wouldn’t cost so much if it were actually insurance, idiots going to the er for a headache the ones driving up costs. Every time I go in there are at least 5 female 20 somethings with a baby daddy not a fourth of their weight holding onto the kids while she whines and moans in pain from her cold.
yes arrogant GOP members, who all have Doctor’s degrees that allow them to diagnose by just looking at a person from 10 feet away, yes you have health concerns that are much more important and serious than lowly poor people.
A fever of 103 is a health concern, losing a limb is a health concern, going in to the er for the flu just to get attention is not necessary.
we need to stop sending people to medical schools and just put GOP cheerleaders in hospital reception rooms to tell us who’s sick and who isn’t.
Why are you in the ER so much, huh? Are you a 1/4 of your ‘ol lady?
Typically you do need to take your kids in when they are under 3.
You’re offering an anecdote. You have no information about these individuals’ medical conditions. You see they are female, have children, and are overweight–so you despise them, assume they’re not actually ill, and blame them for the cost of insurance.
Please try factoring in the cost of CEOs’ multi-million dollar salaries for the cost of policies from the for-profit corporations.
I’ll go along with the inflated salaries part. But I do know a lot of people who being on welfare, don’t have to pay, that do use the ER’s as their primary care givers. This is one of the problems with Canadas health care system. Not that they aren’t allowed primary physicians, they are, it’s just more convenient to run to the ER for minor ailments than make an appointment to see their doctor.
I have seen the same thing in my experience working with individuals.
What are you talking about? insurance companies dont care about averaging salaries they care about getting the most money someone would be willing to pay.
A significant portion of your health insurance premium dollar goes towards the CEO’s grossly inflated salary.
See my theory is that everyone who works for the insurance company has a grossly inflated salary, people doing high school level paperwork all day for 75k a year to me is just as ridiculous as someone who owns a multi billion dollar company and pays them self 100 million of it a year.
Note that any improvements will come from ACA. And LePage and the Rs want to get rid of it? More like save their bacon (and counteract unwise decisions and policies).
Older people tend to be more conservative. I bet many of those now facing higher insurance costs were in favor of LePage’s plans, believing he would never, never, hurt them–it’s always supposed to be someone ELSE that gets hurt by Republican policies–and now it’s turned out to be THEM.
Another way LePage and the GOP (or TeaOP) are sticking it to Maine seniors. It’s going to be a Democratic sweep in November. While certainly not perfect, at least Democrats don’t get a kick out of knocking the old folks down and then kicking them in the gut while they are still on the ground.
I remember when I was a republican. How did it take so long for me to realize how blind I was to such corruption with-in the party.
bye bye republicans. I hope a lot more republicans wake up.
DISCRIMINATION!
These older people have paid into insurance for 40-50 years.
And the northern part of the state with many elderly and TP’ers voted him into office.Nice payback.
That was the most ridiculous comment I have ever heard in this article.
Joel Allumbaugh, health care policy director for the conservative Maine Heritage Policy Center, called the report “largely positive.” “This market has been in a death spiral and PL 90 begins to reverse that trend,” he wrote.
If older and rural Maine resident can’t afford the 10-15% premium increases, how the heck are they going to pay for private health insurance? He says the number of insured will grow? That is the same old insane comment that all the Heritage Institute people always say.
This bill is doing exactly what the democrats said it would do months ago, raising premiums for the people who are most likely not going to be able to afford them.
There is always something to be considered when raising the cost of any item, affordability. With older, more rural Mainers already paying more for everything else they buy….health insurance will most likely be the first thing they have to cut.
I just can’t believe the stupidity of supposedly educated people.
I think you need to read the article more closely as the conclusions you draw are incorrect. The article is clear: overall, the market will see premiums decrease. A small percentage of older Mainers will see increases–but a higher percentage will see significant decreases. So, yes, there are some losers, but for most Maine people, this is a winning proposal.
You are out of touch with reality. Maine has one of the Oldest Population in the US.
I think you need to read the article more closely
{“It validates MECEP’s analysis last spring which warned that while some individuals and businesses would realize lower rates, others would see their costs increase. PL 90 is a flawed law that the governor and the Legislature must act to fix.”}
Really??
I think you are not familiar with the reality of what older Mainers are already paying. This is not a winning proposal if you are on the end that is being sacrified.
Let me give you a first grade primer on insurance, since you think I am incorrect. The problem with this bill is that it is cherry picking. That is a term that insurance companies use when they only want to take the low risk people. You cherry pick, that way you offer a low premium, and price out the ones that you do not want.
Insurance, especially group insurance is about spreading the risk. Just because you are young and healthy does not mean that you cannot develop a serious, EXPENSIVE disease. By pooling the healthy and the unhealthy, you develop a rate that is more realistic, and benefits all.
The young people will eventually age, and they will no longer be cherry picked by companies.
You fail to see the larger picture. This law was supposed to bring out of state companies in to write policies. Check the facts, this has not happened.
I suspect you will always throw the older less healthy people under the bus. Just remember, you will be one of those people one day.
The overall aspect of this will result in more Maine Care clients. So, in reality, it will not be a rate decrease for anyone, as we all will pay higher taxes.
Typical Republican drivel.
Leave it to the BDN and the MCEP to put a negative spin on such a positive report. 80% of the individual market should see a decrease! When has that ever happened in Maine? – certainly not with Dirigo.
Thank you for pointing out what so many others will miss about this story.
(Should)
Is a speculative
Insurance should not discriminate against age or any other demographic.
After all it is a means to disperse risk out amongest the population.
Once you target any particular group you are undermineing the very concept of insurance!
Don’t worry, Obama already promised that his plan will save everyone $2,500 a year. It will actually save people much, much more because they will not have access to doctors, so they won’t be able to pay for care.
OBAMA Care hasn’t even kicked in yet, wait until it does and you will begin to realize what he has done to all of us. If you think you pay now, just wait and see what you will pay under OBAMA Care especially when you needs are greater than basic care.
simply untrue
I have been in healthcare for 40 years and it is true. Preventive care will be somewhat like we have now but if you need care greater than Preventive care, than you will see what it cost you and then you will understand. If you have insurance, watch what it will cost you in premiums. I went from 80/20 rule and I paid $225/Mthly with a very small deductible less than $200. Plus a co pay for office visits. Today I pay $375./Mthly with a $4,000 deductible and I pay all office visits out of pocket until I reach my deductible. My physicians now report my weight, ask if I smoke (no I don’t smoke) and they ask if you drink alcohol and a host of other questions. This data is reported back to the Gov and then you deal with it. I don’t want to be disrespectful but you and a host of others have no idea what we are in for. Now that is true. Keep this in mind, those who are overweight, smoke, drink alcohol and do things that can cause health issues will pay a much higher UHC premium.
So what is the problem…those who use the system more, pay more; those who use the system less, pay less. Is that not how a market is suppose to work?
The cost of insurance in Maine skyrocketed when the companies were mandated to cover pre-existing conditions. As a result, all but two companies (Blue Cross was one) pulled up stakes and stopped writing policies here. As with all things, the free market evaporated and so did cheap insurance. Talk about “crap”- just wait until Obamacare takes effect and people discover that their care is either approved or declined by a bunch of government bureaucrats with degrees in economics, not medicine. As a retiree, I think I’ll just dig a whole out in my garden and wait to fall into it when I die. My family will only need to pay my neighbor to cover me up with his backhoe because Uncle Sam will only pay $250 for my funeral.
Is it a terrible thing to make sure people are covered for pre-existing conditions?
your care is either approved or declined now– by the insurance companies– and if you think the free market will lower health insurance costs, you’re dreaming
”
The cost of healthcare in the United States is 62 percent higher than that in Switzerland, which has a similar per capita income and also relies substantially on private health insurance.
Meanwhile, Americans receive comparatively little actual care, despite sky-high prices driven by expensive tests and procedures. They also spend more tax money on healthcare than most other countries, the study showed.
U.S. public spending on healthcare reached 8 percent of the economy versus a 7 percent OECD average in 2009, the latest year for which comparison figures are available
Pharmaceuticals also cost about 60 percent more than in a range of European countries.
Pearson said one reason prices are higher in the United States is that the healthcare system lacks what other countries have: an effective government mechanism that acts to keep prices down.
“That’s simply not there in the U.S. system. So it’s a structural defect,” . said Mark Pearson, head of the OECD health division
Why don’t we just herd all of the ‘undersirables’ (older and elderly, and North Woods people of Maine) into cattle trains and move the out of the State of Maine where we don’t have to worry about them starving to death on our watch trying to survive while paying their ever increasing bills (which by the way, isn’t offset by their dwindling incomes.) It is becoming vividly apparent that the new ideal of “Maine, the way life should be,” is age biased and geographically biased. There was a time I was proud to be a Mainer and even more proud that I grew up in the North Maine Woods where life was hard, but we got by….we now have ‘city-folk’ making it that much more difficult for the ‘woods’ people to survive spiritually, physically, financially and emotionally. I am now anxiously awaiting the day I can say good-bye to this ‘new’ Maine that is increasingly leaving a bitter taste in my mouth.
….
Yes! And they simply cannot afford any cuts. My heart goes out to everyone trying to make it work, because they inevitably climbing a hill they cannot conquer. What is the reasoning behind making it harder for the already impoverished? Is there no compasion left in this state?
….
People still do help each other. I write story after story about people banding together to help a neighbor who has an illness, or has lost a home to a fire, or suffered some other hardship. They host public suppers and auctions and yard sales and more where they raise quite a bit of money to help out a needy individual or family. Compassion is alive and well, but there are those who believe compassion begins at home, not at the steps of Augusta. Taxpayer money funneled through the government bureaucracy is an inefficient way to extend a helping hand in most cases.
I will agree with you on one point, government bureaucracy is not the most efficient method. However, if we depended on people like you, it sounds like your helping hand would be amputated and put in your wallet. That is what I have gathered from all your posts, but since I don’t know you, I only know you by what you have written. Honestly, it does sound scripted.
Thanks for the honesty, but you need to stick to the issues, not the individual. You don’t know me. My writing may sound scripted because I am a writer.
But, looking at the post you replied to from a professional standpoint, and combining that with your impression that it sounds scripted, I totally have to agree. “Compassion is alive and well, but there are those who believe compassion begins at home, not at the steps of Augusta” Whoa. It does sound like something from a politician’s mouth that has been repeated over and over. Sorry about that.
This new Maine is attempting to make Maine a better place by instituting policies that are sustainable and bringing prosperity back to Maine citizens. The old Maine would have us all living subsistence lives. Sure, they would give us access to second rate health care, enough rent subsidy to rent a two room dump, fuel assistance that will cover a tank of oil for a winter season that requires at least 5 tanks full, enough food assistance so we can buy a lifetime of Kraft mac ‘n cheese and corn-syrup sweetened soda pop. I guess as long as we have enough tv to occupy our empty, cold hours, we’ll be happy as the proverbial clam. To that “comfortable, government funded” existence, I say “No, thanks.” I’ll take my chances with opening opportunities for those willing to work hard. Better jobs, more competitive insurance rates, a healthy, local food supply system, lower taxes–in a word, prosperity. Something government funding will not bring to Maine.
FYI – I am not a welfare recipient, nor have I ever been – I am however, aging as everyone else does and I live NORTH of Bangor – and I do NOT appreciate being descriminated against and being forced to pay more for healthcare and insurance because of my age and where I chose to live. Before one submits a chaste remark dripping with audacity and distate for the ones who are less fortunate in Maine, one should put oneself in the others shoes……hard times can befall anyone and a lawmaking system that makes it harder for the less fortunate – in age and location is not a just lawmaking system. Don’t ASSUME – you know what it can do…….
It’s not discrimination to charge an age demographic more for a service that they access far more than others–any more than it is discrimination to charge higher rates for young, unmarried drivers for car insurance. The good news is once you reach 65 you can enroll in Medicare insurance. Shouldn’t smokers have higher health insurance rates? I mean, that’s the insurance business–to gauge risk and set rates based on that. It stinks, but it seems to be the way Americans of previous generations decided we would run our health care system.
I didn’t imply you were on welfare. There’s no shame to being down on your luck and needing some help. I know how easily hard times could befall me–but until they do, I will plug on, paying my way the best I can.
Chronic health conditions and death can strike anyone – indescriminately; young or old – so how is it justification to charge only the elders and rural families more? Rural families already pay more for gas, fuel, and groceries – enough is enough. This is another ‘new’ decision made by our lawmakers – yet again making it harder for people to afford to work and live in “New” prosperous and innovative Maine – the Maine the Rich can retire to an peruse the National Parks in their leisure. My heart bleeds for the elders and country-folk of this State being pushed by the wayside and left to their own devices by a government that can no longer see beyond the bright lights of it’s cities.
There is no hope for the great one…..he is a modern day scrooge, only interested in money that he can keep in his own pocket. Read between the lines, and the typical talk radio mentality.
I wish the article would define “older”. Are we talking over 65? Or over 30? It is really unclear, but it is important. Older Americans, as in those aged 50+ generally have more financial stability according to national statistics. So, yes, those older folks, who also tend to use health services at a higher rate, can certainly absorb a higher premium for the most part. I’m not saying they’ll do it joyfully, but I bet most will do it.
This report does not state that these “older, rural” Mainers are also “low-income”. Most older folks who have private insurance are probably fairly comfortable financially. Not all—but probably most. So I get back to my original point: define “older”.
I’d like to see those statistics. Obviously, you’re not familiar with Washington county. Twenty percent below the poverty rate vs 12% for the rest of the state. Median household income is 2/3 the rest of the state. Population over 65 is 20% vs 16% for the rest of Maine. Rural? You betcha. Older? Yes sirree. Financially stable? Not even close.
I am familiar with Washington County, but just because the county has a higher rate of older and poorer people does not mean every citizen in the county is old and poor. For those who can afford to purchase insurance on the private market, or who run a small business that purchases said insurance–those are the people being affected by a higher premium–those are the people I am contending can absorb an increase. But, as I also said, I don’t expect them to be happy about it–but it won’t drive most people into bankruptcy.
Check your statistics…..the number of insured people in private plans has DECREASED. Even the insurance companies acknowledge this.
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Wrong again….those of us who have private insurance are not fairly comfortable financially. We are responsible, we choose to live without many things that most people consider essential. We do not want to lose our homes and what little savings we may have to an illness.
By the way, you need to discard your national statistics, you are in Maine. We do not fit the national model, and neither do a majority of the less populated states.
A lesson in economics, if we older people pay more for insurance, that is less money that is spent on other things in Maine. So in essence, these cuts in premiums are not helping the businesses in Maine, rather they are taking money from small businesses in the rural parts of the state.
Economics is all about equilibrium. Take a dollar out of the economy, and that dollar is missed. What we are seeing here is an income transfer from smaller businesses to large ones, especially insurance companies.
Why can’t everyone be allowed to (uhh for this to work you must ) first – buy into MaineCare – on a sliding scale according to income – the basic Wall Mart plan – and if you want the Platinum plan – you can buy it from private insurance. The insurance companies are making obscene profits on basic plans – why not let the state make the profits – and wait – perhaps lower taxes. Also eliminate ALL employer provided insurance – everyone has to pay their own way. That will immediately lower premiums as union mandated coverage would no longer be allowed. I never understood how unions can mandate that taxing authorities purchase health insurance from a private company – how is that free market?
What no one seems to talk about is that the State of Maine’s highest population is elderly. And, we are a rural state. Plus, I find it strange that the Republicans (including LePage) who supported and passed this legislation are trying to eliminate the federal health bill which this article claims will help reduce costs.