Republicans in the Legislature are counting their Supreme Court votes before they’ve been cast. As is the case with many in their party, Republicans in Augusta are banking on the high court finding that some or all of the federal Affordable Care Act — better known as Obamacare — will be declared unconstitutional.
Being privately hopeful or even confident of a court ruling is one thing. But failing to do the work required by the federal law to bring funds into Maine and help middle class families have health coverage is unconscionable.
Under the law, states have until Jan. 1, 2014, to create health insurance exchanges. The exchanges will exist on a website at which those who have no health care plans through their employers and those who operate small businesses can shop, comparing policies on coverage and price, and choose a plan that makes sense for their circumstances and budget.
Insurers will become more competitive on price and coverage because they will be on a level playing field throughout the country. Currently, insurance companies often do business on a different basis, state by state.
Maine’s Department of Health and Human Services has accepted $6 million from the feds to implement the exchange, but has done little to create it. At stake is financial help for thousands of Mainers in getting health insurance. Those eligible for the exchange are middle-income earners who are not eligible for MaineCare.
And it’s real money — up to $10,000 in an upfront tax credit for those who are eligible. Those using the exchanges will pay a portion of the premiums.
Republicans in the Legislature want to create a bare-bones version rather than fully ramp up the program and test it, a move Democrats think will doom it. A consumer-directed board of directors must be formed. And a mechanism to pay the state portion of operating the exchange must be devised. That work will lead to political conflict; should it be surcharges on insurance claims, an assessment on insurance companies? Putting off that fight makes little sense.
The idea behind the exchanges is to make it easy for consumers to understand their options for health insurance and to shop with confidence. Democrats fear that instead of an exchange that caters to and protects the consumer, the governor will create a board made up of insurance company representatives or run the exchange himself. Such outcomes would hurt self-employed Mainers and others who need to find a way to get coverage without going broke paying for it.
If a state fails to create an exchange, the federal government will step in and create one for it. Waiting to do the work to implement this part of the federal health care law is short-sighted at best, and at worst, subversive.
Ironically, as an Associated Press analysis found, states that had done little to prepare for the Affordable Care Act are also the states that have many uninsured residents.
There is no silver bullet to bring health care costs for Maine and the nation into the reasonable range. It will take vigilance to ensure that laws enacted to protect consumers and tamp down costs are working as they should.
Given the nation’s demographics, with 76 million baby boom Americans now sliding into their senior years, the work will continue for decades. Watching and waiting for the demise of a duly enacted plan while Mainers struggle to pay their health bills is shameful.