Recent federal changes make coverage more affordable for Maine individuals and families as Open Enrollment approaches on Nov. 1, 2022

AUGUSTA— The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) announced on Oct 17th, that Maine people can now visit CoverME.gov, Maine’s official Health Insurance Marketplace, to preview affordable health plans for 2023 during the “window-shopping” period in advance of Open Enrollment kicking off on November 1, 2022.

During both the window-shopping period and Open Enrollment, consumers can use the Plan Compare tool to evaluate available private health insurance plans and estimate their costs without having to sign up for an account or complete a full application. The tool also allows consumers to check whether their preferred health care providers are included in each plan’s network, and to view information about coverage and out-of-pocket costs for prescription drugs.

“We encourage all Maine people who need health insurance to visit CoverME.gov to explore affordable health plan options,” said DHHS Commissioner Jeanne Lambrew. “Even if you haven't qualified for financial assistance in previous years, it's worth checking again because coverage is more affordable than ever and there are new options for families."

CoverME.gov was created as Maine’s State-run marketplace as a result of the Made for Maine Health Coverage Act, which Governor Mills signed into law in 2020 following its unanimous passage by the Maine Legislature. During CoverME.gov’s first Open Enrollment in 2021-2022, more than 66,000 Maine people signed up for 2022 coverage, an increase of more than 10 percent from 2021 and reversing declines in Marketplace plan selections since 2017.

Next year, thousands of Maine people will save hundreds of dollars on average on their CoverME.gov health care premiums due to enhanced premium tax credits extended through 2025 as part of the Inflation Reduction Act passed by Congress and signed into law in August. In addition to increasing affordability for people already eligible for financial assistance, the new law allows those with income over 400 percent of the poverty level to benefit from financial assistance if coverage would otherwise be unaffordable for them. This provision particularly benefits older Mainers and those in rural areas, who often face higher premiums. In coverage year 2022, over 80 percent of consumers received financial assistance through CoverME.gov, with an average Advance Premium Tax Credit of $470.

Additionally, President Joe Biden announced last week that the Administration has finalized a rule to fix the so-called “family glitch,” which will expand health insurance to an estimated 200,000 uninsured Americans, including 34,000 people in Maine. As a result of the prior interpretation of policy, employer-based health insurance had been considered “affordable” if the plan was affordable for the employee even when their family members couldn’t afford it — making those family members ineligible for Affordable Care Act financial assistance. Under the recent federal change, family members can access financial help to enroll in a plan for 2023 coverage through CoverME.gov if they do not have any source of affordable coverage.

Also new in 2023, a new insurance carrier, Taro Health, will join Anthem, Community Health Options, and Harvard Pilgrim Health Care in providing health plans through CoverME.gov. Taro Health will offer plans to consumers in Cumberland County while the other three carriers will continue to offer plans to consumers in all Maine counties. Statewide, a total of 118 health plans will be offered.

Through CoverME.gov, Maine residents can compare qualified health insurance plans that include a comprehensive set of benefits and apply for help to lower the cost of coverage. Open enrollment runs from November 1, 2022 to January 15, 2023. The enrollment deadline for coverage beginning January 1, 2023, is December 15, 2022. Consumers who enroll between December 16, 2022 and January 15, 2023 will have coverage starting on February 1, 2023.

As in previous years, those who already have a plan through CoverME.gov will be automatically re-enrolled in their current plan or the most similar offering from their health insurance carrier. OHIM still encourages consumers to update their information at CoverME.gov and review their options to make sure they choose the plan that best meets their needs and budget.

People who apply through CoverME.gov who are eligible for MaineCare will have their application sent to MaineCare for review. Eligible Maine people can enroll in MaineCare at any time of year.

CoverME.gov is part of Governor Mills’ successful efforts to ensure Maine people have access to health insurance, evidenced last month by a Census report showing Maine’s uninsured rate experienced the largest drop in the nation in recent years.

Governor Mills’ efforts to expand health care additionally include:

Expanding Medicaid: Medicaid expansion was approved overwhelmingly by Maine people in 2017 at the ballot box. After being blocked by the previous administration, implementing expansion was Governor Mills’ first official act as Governor and was her Administration’s first step in improving health care for Maine people. The Federal government pays 90 percent of the cost of this coverage, which has supported hospitals’ cost of caring for patients that were previously uninsured, a move that has been especially important during the pandemic.

Putting Affordable Care Act Protections into State Law: In 2019, just weeks after expanding Medicaid, Governor Mills also signed into law bipartisan legislation to codify insurance protections for people with pre-existing conditions, ensuring that Maine people with cancer, asthma, or other chronic conditions don’t get charged more or denied private coverage altogether from insurance companies regulated by the state.

Making Health Insurance More Affordable for Small Businesses: Thanks to a bill Governor Mills proposed and signed into law, small businesses will see their first annual average reduction in health insurance premiums since at least 2001, while average small group premiums in many other northeast states will increase. The Governor has also launched the Small Business Health Insurance Premium Relief Program that lowers the cost of monthly health insurance premiums for small businesses and their employees. It has saved more than $20 million for 5,764 small businesses in Maine and 46,348 Maine people – employees and their families – as of June 2022.