HOW HEALTH INSURANCE REFORM WILL BENEFIT MAINE

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	HOW HEALTH INSURANCE REFORM WILL BENEFIT MAINE Topics on this page: The New Numbers: Health Insurance Reform Cannot Wait in Maine Stable and Secure Health Care for Maine The Health Care Status Quo: Why Maine Needs Health Reform The New Numbers: Health Insurance Reform Cannot Wait in Maine Last week, the U.S. Census released its new numbers for the uninsured. The results are sobering and confirm that health insurance reform cannot wait another year. Nationwide, the number of uninsured increased from 39.8 million in 2001 to 46.3 million in 2008. The facts below underscore the urgency of health insurance reform for residents of Maine. The status quo is not an option. The number of uninsured in Maine has increased from 129,000 in 2001 to 137,000 in 2008. The percent of non-elderly adults without insurance increased from 14.3% to 14.5%. And this number only considers people who are uninsured for an entire year – it does not include people in Maine who have more recently lost coverage through the recession, or who had shorter gaps in their coverage. Private coverage is eroding under the status quo. The percentage of people with employer-based coverage decreased from 71.8% of the population in 2001 to 67.9% in 2008. More workers are being left without protection from health care costs. Too many workers in Maine do not have health coverage, at 97,000 in 2008. And the proportion of workers from Maine without insurance has increased, from 13.5% in 2001 to 14.8% in 2008. The problem of the uninsured is a problem that crosses income brackets. The new Census numbers also drive home the fact that everyone in Maine is vulnerable to losing health insurance. The percentage of high income people without insurance has increased from 5.4% in 2001 to 6.6% in 2008. Stable and Secure Health Care for Maine How Health Insurance Reform will Benefit Maine LOWER COSTS FOR RESIDENTS OF MAINE Ending the Hidden Tax – Saving You Money: Right now, providers in Maine lose over $283 million in bad debt which often gets passed along to families in the form of a hidden premium “tax”.¹ Health insurance reform will tackle this financial burden by improving our health care system and covering the uninsured, allowing the 37 hospitals² and the 4,898 physicians³ in Maine to better care for their patients. Health Insurance Premium Relief: Premiums for residents of Maine have risen 105% since 2000.⁴ Through health insurance reform, 107,000 to 129,400 middle class Maine residents will be eligible for premium credits to ease the burden of these high costs.⁵ Strengthening Small Businesses: 24,923 employers in Maine are small businesses.⁶ With tax credits and a health insurance exchange where they can shop for health plans, insurance coverage will become more affordable for them. Reforms that Reduce Your Costs: Under health insurance reform, insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive. Insurance companies will also have to abide by yearly limits on how much they can charge for out-of-pocket expenses, helping 2,100 households in Maine struggling under the burden of high health care expenses.⁷ INCREASE YOUR CHOICES: PROTECTING WHAT WORKS AND FIXING WHAT'S BROKEN Insurance Stability and Security: Health insurance reform will strengthen our system of employer-based health insurance, with an additional 13,200 people in Maine potentially getting insurance through their work.⁸ Health insurance reform will also ensure that you will always have guaranteed choices of quality, affordable health insurance if you lose your job, switch jobs, move or get sick. Eliminating Discrimination by Insurance Companies: 8% of people in Maine have diabetes⁹, and 29% have high blood pressure¹⁰ – two conditions that insurance companies could use as a reason to discriminate against you. Health insurance reform will build on existing state policies to end discrimination that unfairly charges some people more than others. One-Stop Shopping – Putting Families in Charge: With the new health insurance exchange, you can easily and simply compare insurance prices and health plans and decide which quality affordable option is right for you and your family. These proposals will help the 118,900 residents of Maine who currently do not have health insurance to obtain needed coverage, and it will also help the 63,200 Maine residents who currently purchase insurance in the individual insurance market.¹¹ Guaranteeing Choices: The largest health insurer in Maine holds 71% of the market, which limits the choices that you have for finding coverage.¹² With a competitive public insurance option, you will have more choices and increased competition that holds insurance companies accountable. ASSURE QUALITY, AFFORDABLE HEALTH CARE FOR AMERICANS Preventive Care for Better Health: 27% of Maine residents have not had a colorectal cancer screening, and 15% of women have not had a mammogram in the past 2 years.¹³ By requiring health plans to cover preventive services for everyone, investing in prevention and wellness, and promoting primary care, health insurance reform will work to create a system that prevents illness and disease instead of just treating it when it’s too late and costs more. Improving Care for Children and Seniors: 19% of children in Maine have not visited a dentist in the past year,¹⁴and 23% of seniors did not receive a flu vaccine¹⁵. Health reform will ensure coverage for kids’ dental, vision, and hearing needs, and will promote quality coverage for America’s seniors, including recommended immunizations. ¹ Hospital uncompensated care cost is estimated using a GAO model and the Hospital Cost Reports. Total uncompensated care is computed as hospital uncompensated care divided by 63% (Hadley and Holahan’s study on “The Cost of Care for the Uninsured” for Kaiser in 2004 found that hospitals account for 63% of total uncompensated care). Data expressed in 2009 dollars using Centers for Medicare and Medicaid Services, “National Health Expenditure Data.” ² 2007 AHA Annual Survey Copyright 2009 by Health Forum LLC, an affiliate of the American Hospital Association, special data request, March 2009. Available at http://www.ahaonlinestore.com. ³ American Medical Association, Physicians Professional Data, year of data 2008, copyright 2008: Special Data Request. ⁴ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2000, Table II.D.1. Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D. Projected 2009 premiums based on Centers for Medicare and Medicaid Services, “National Health Expenditure Data.” ⁵ U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008. ⁶ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table II.A.1a. ⁷ Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2006. ⁸ U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007. Calculations based on Congressional Budget Office. Letter to the Hon Charles Rangel on America’s Affordable Health Choices Act, July 14, 2009. ⁹ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008. ¹⁰ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. ¹¹ U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008. ¹² American Medical Association. (2008,2009). "Competition in health insurance: A comprehensive study of U.S. Markets: 2008 Update," American Medical Association. ¹³ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. ¹⁴ Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health. ¹⁵ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. The Health Care Status Quo: Why Maine Needs Health Reform Congress and the President are working to enact health care reform legislation that protects what works about health care and fixes what is broken. Mainers know that inaction is not an option. Sky-rocketing health care costs are hurting families, forcing businesses to cut or drop health benefits, and straining state budgets. Mainers are paying more for less. Families and businesses in Maine deserve better. MAINERS CAN’T AFFORD THE STATUS QUO Roughly 783,000 people in Maine get health insurance on the job¹, where family premiums average $14,304, about the annual earning of a full-time minimum wage job.² Since 2000 alone, average family premiums have increased by 105 percent in Maine.³ Household budgets are strained by high costs: 15 percent of middle-income Maine families spend more than 10 percent of their income on health care.⁴ High costs block access to care: 10 percent of people in Maine report not visiting a doctor due to high costs.⁵ Maine businesses and families shoulder a hidden health tax of roughly $800 per year on premiums as a direct result of subsidizing the costs of the uninsured.⁶ AFFORDABLE HEALTH COVERAGE IS INCREASINGLY OUT OF REACH IN MAINE 9 percent of people in Maine are uninsured, and 75 percent of them are in families with at least one full-time worker.⁷ The percent of Mainers with employer coverage is declining: from 63 to 60 percent between 2000 and 2007.⁸ While small businesses make up 79 percent of Maine businesses,⁹ only 45 percent of them offered health coverage benefits in 2006.¹⁰ Choice of health insurance is limited in Maine. WellPoint Inc. (BCBS) alone constitutes 78 percent of the health insurance market share in Maine, with the top two insurance providers accounting for 88 percent.¹¹ Choice is even more limited for people with pre-existing conditions. In Maine, premiums can vary based on a modified community rating structure, and coverage can exclude pre-existing conditions in some cases. MAINERS NEED HIGHER QUALITY, GREATER VALUE, AND MORE PREVENTATIVE CARE The overall quality of care in Maine is rated as “Average.”¹² Preventative measures that could keep Mainers healthier and out of the hospital are deficient, leading to problems across the age spectrum: 13 percent of children in Maine are obese.¹³ 15 percent of women over the age of 50 in Maine have not received a mammogram in the past two years. 27 percent of men over the age of 50 in Maine have never had a colorectal cancer screening. 77 percent of adults over the age of 65 in Maine have received a flu vaccine in the past year.¹⁴ The need for reform in Maine and across the country is clear. Maine families simply can’t afford the status quo and deserve better. President Obama is committed to working with Congress to pass health reform this year that reduces costs for families, businesses and government; protects people’s choice of doctors, hospitals and health plans; and assures affordable, quality health care for all Americans. ¹ U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007. ² Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D. Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationalhealthexpenddata/. ³ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2000, Table II.D.1. Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D. Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationalhealthexpenddata/. ⁴ Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2006. ⁵ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. ⁶ Furnas, B., Harbage, P. (2009). "The Cost Shift from the Uninsured." Center for American Progress. ⁷ U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008. ⁸ U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007. ⁹ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table II.A.1a. ¹⁰ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2001, 2006, Table II.A.2. ¹¹ Health Care for America Now. (2009). "Premiums Soaring in Consolidated Health Insurance Market." Health Care for America Now. ¹² Agency for Health Care Research and Quality. 2007 State Snapshots. Available http://statesnapshots.ahrq.gov/snaps07/index.jsp. ¹³ Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health. ¹⁴ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007.