A Guide To The Upcoming Health Insurance Market In Maine And What It Means For You

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Maine will launch a state-based health insurance marketplace early next month, a process that will synthesize purchasing plans for coverage under the Affordable Care Act.

The state has been striving to have its own market for over two years. A 2020 law that allowed the state to create its own marketing, outreach and enrollment programs was a primary healthcare goal at the start of Democratic Governor Janet Mills’ first term.

Maine will join 15 other states – including all of New England except New Hampshire – using a state-based market instead of the federal market after approval from President Joe Biden’s administration the state plan Monday. Here’s what buyers need to know.

What makes the Maine market different from the federal market?

Maine has been using a federal-local hybrid since the registration period last year. The state manages marketing, outreach, and customer service while the Healthcare.gov platform is used for applications and registration.

After November 1, everything will be centralized on the Maine platform, called CoverME.gov. This means that people will buy, apply and register in one place.

How will this affect health care purchases?

Almost 60,000 Mainers have been covered through the Affordable Care Act markets this year, most individuals or families eligible for grants. Centralizing the market should make it easier for Mainers to see options, said Ann Woloson, executive director of Maine Consumers for Affordable Health Care.

State-run markets can also create their own special listing period or extend listing periods without depending on the federal government, Woloson said.

“It’s more like a one-stop-shop,” she said.

In addition to market plans, those eligible for MaineCare, the state version of Medicaid and its extended version will have their requests sent directly to this office, rather than having to apply separately.

When should I register and who offers packages?

Buyers will be able to see plan options on October 15, with registration starting November 1. They will have until December 15 to get coverage that begins January 1, 2022, although open enrollment continues for another two weeks after that.

A special registration period from February 15 to July 31, more than 9,100 new people signed up for a plan, more than double the number last year.

Woloson said the bump was likely caused by two factors: people losing their jobs due to the pandemic and needing health insurance, and a federal grant provided by Congress through the American Rescue Plan Act making these more affordable plans. These grants are expected to expire by the end of 2022, but efforts are underway in Congress to make them permanent.

There is only one nonprofit health insurance cooperative operating in Maine, based in Lewiston Community health options, one of three left in the country on an original of 23. Harvard Pilgrim and Anthem also have market plans and will do so in 2022.


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