Author Topic: State of Maine gets waiver from ObamaCare provisions. (1st State)  (Read 431 times)

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Maine gets break in federal health care overhaul
Published: Tuesday, 8 Mar 2011 | 7:44 PM ET Text Size
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http://www.cnbc.com/id/41978227
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PORTLAND, Maine - The federal government Tuesday granted Maine a waiver of a key provision in President Barack Obama's health care overhaul, citing the likelihood that enforcement could destabilize the state's market for individual health insurance.

The U.S. Health and Human Services department said in a letter it would waive the requirement that insurers spend 80 cents to 85 cents of every premium dollar on medical care and quality improvement. Instead, the letter said, the state could maintain its 65 percent standard for three years, with the caveat that HHS intends to review the figures after two years.

The decision makes Maine the first state to receive a waiver of the requirement. Similar requests are pending from Kentucky, Nevada and New Hampshire.

In seeking the waiver, Maine Insurance Superintendent Mila Kofman feared that one of three major insurers offering individual plans in Maine would withdraw from the market altogether if the federal requirement remained in place. The insurer, MEGA Life and Health Insurance Co., has 37 percent of the state's individual market.

MEGA's departure from the market would carry the "reasonable likelihood of destabilizing the Maine individual market," with costly ramifications for MEGA's policy holders, wrote Steven Larsen, an HHS deputy administrator.

"We appreciate the evidence-based approach HHS took with our request and in working with us," Kofman said in a statement.

Maine's individual insurance market has been volatile, with big premium increases attributed in part to the small number of enrollees and lack of competition. There have been fears the market could collapse altogether.

Anthem Blue Cross Blue Shield has the biggest market share with 18,297 individual policies, followed by MEGA Life & Health's 13,732 and Harvard Pilgrim Health Insurance's 4,953. Harvard Pilgrim provides coverage through DirigoChoice, the state-subsidized health insurance program.

An official from MEGA Life & Health didn't immediately return a call from The Associated Press.

The Affordable Care Act allows states to petition to delay the federal standard until 2014 on how much money from premiums must go to medical care for the individual market. Administrative costs tend to be higher on those plans than on insurance plans provided through employers.

The federal law envisions that by 2014 there will be health insurance exchanges to provide individuals with new, affordable options for health care options.

Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Skip8282

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Re: State of Maine gets waiver from ObamaCare provisions. (1st State)
« Reply #1 on: March 08, 2011, 06:30:27 PM »
Doh.  Let's see, I'll predict right now the most of the liberals here will avoid this like the plague...as they usually do most tough issues.

They seem to have plenty of time to troll after 33 though.   ???

225for70

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Re: State of Maine gets waiver from ObamaCare provisions. (1st State)
« Reply #2 on: March 08, 2011, 06:32:05 PM »
ObamaCare is bad enough..At the very least they should implement the same rules to everyone...Macdonalds/maine shouldn't get any exemptions assuming Small business don't get the same treatment.

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Re: State of Maine gets waiver from ObamaCare provisions. (1st State)
« Reply #3 on: March 08, 2011, 06:43:41 PM »
In seeking the waiver, Maine Insurance Superintendent Mila Kofman feared that one of three major insurers offering individual plans in Maine would withdraw from the market altogether if the federal requirement remained in place. The insurer, MEGA Life and Health Insurance Co., has 37 percent of the state's individual market.

MEGA's departure from the market would carry the "reasonable likelihood of destabilizing the Maine individual market," with costly ramifications for MEGA's policy holders, wrote Steven Larsen, an HHS deputy administrator.


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Ha ha ha- we warned of this, yet somehow the geniuses in the WH could not figure this out. 

Kazan

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Re: State of Maine gets waiver from ObamaCare provisions. (1st State)
« Reply #4 on: March 08, 2011, 07:14:29 PM »
Why would they need a waiver, seems to me the "law" was ruled unconstiutional
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Re: State of Maine gets waiver from ObamaCare provisions. (1st State)
« Reply #5 on: March 09, 2011, 12:13:53 PM »
Great news: HHS adds 1,328,381 waivers to ObamaCare (Give or take a few thousand)
Hotair ^ | 03/09/2011 | Ed Morrissey


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Well, give or take a few thousand; that’s as accurate as the 2010 Census data for Maine. The entire state got itself a waiver from the core provisions of ObamaCare, which requires insurers to spend 80% of their premiums directly on provider care or offer rebates for the difference. Maine requested and received a pass on the law so that insurers in the state could continue to operate at the 65% level:

Maine health insurers are getting a temporary waiver from the health reform law’s requirement that they spend at least 80 percent of premiums on care, federal regulators decided Tuesday. …

Specifically, HHS points out that three insurers make up the bulk of Maine’s individual insurance market: Anthem Blue Cross Blue Shield of Maine (49 percent), MEGA Life and Health Insurance Company (37 percent) and HPHC Insurance Company (13 percent). MEGA had told Maine during preliminary discussions that it “would probably need to withdraw from this market if the minimum loss ratio requirement were increased.”

Maine won’t be alone in the waiver business, either. New Hampshire, Nebraska, and Kentucky all have applied for waivers, too. Combined, that would add 3,912,691 waivers to the list — since exempting an entire state from the requirements means every resident gets a pass.

This prompts plenty of questions, chief among them the 80% figure itself. How exactly did Congress arrive at that figure? In the case of Maine, this is doubly ironic, because Maine has its own version of ObamaCare already, complete with a “public option,” DirigoChoice. Maine already has universal-coverage mandates, level or “community pricing” for premiums, and bars on pre-existing coverage denials. How did that work out in Maine? Poorly. The average monthly premium for a single male at 30 years of age in 2009 was $762, more than triple what it was in neighboring New Hampshire. The promised “savings” from this universal program never materialized, and the DirigoChoice plan had to be rationed and additional taxes imposed.

If Maine’s own ObamaCare precursor had worked to achieve cost control, then why does the state ration entry into its public option? Furthermore, if such a program really does control cost and overhead, then why can’t the state’s insurers meet the arbitrary 80% threshold set by Congress without having to shut down its business?

The waivers may as well encompass the entire United States, since these economic problems will arise wherever ObamaCare is attempted. Better yet, instead of issuing 300 million waivers, why don’t we scrap the program and start over from scratch — this time with actual reform aimed at eliminating third-party payer interventions rather than expanding them?



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Only 56 states to go!