As of November 1, Mainers can shop for health care plans through the federal insurance marketplace at healthcare.gov. Consumers have until December 15 to buy a marketplace plan, and coverage will begin on January 1, 2020.
The healthcare.gov insurance marketplace was created by the Affordable Care Act of 2010. The landmark health reform law has improved health care in Maine by making it more affordable and expanding coverage to tens of thousands of previously uninsured Mainers.
Here are five numbers to know as open enrollment begins:
$10: Monthly premium for six of every 10 healthcare.gov enrollees in Maine next year
Research by Get America Covered —a health advocacy organization founded by former officials from the Centers for Medicare and Medicaid Services, or CMS — reveals that 59 percent of Mainers enrolled through the federal exchange can find a plan for $10 or less per month. Roughly three-quarters of enrollees will find plans that cost $75 or less. In 2020, premiums will drop for the second year in a row, according to CMS, falling by 6 percent after an 8 percent decline in 2019.
64,844: Mainers covered through healthcare.gov in 2018
In 2018, an average of 64,844 Mainers were enrolled in a plan through the ACA’s individual marketplace. Most of these enrollees receive financial assistance to afford premiums.
Complete figures for 2019 are not yet available, but initial reporting from CMS found that 66,300 Mainers were enrolled in a plan as of March 2019. These preliminary figures are usually slightly higher than the final monthly enrollment numbers, as some people drop their plans during the year. Based on prior year data, MECEP estimates average monthly enrollment in 2019 will be around 63,000.
40,000: Fewer uninsured Mainers since the ACA took effect
The major provisions of the ACA took effect in 2013. Since then, Maine’s rate of uninsured non-elderly adults has declined from 15.9 percent to 11.5 percent. This represents approximately 40,000 more Mainers with insurance coverage. This number is expected to fall even further when 2019 numbers are reported, reflecting coverage from Medicaid expansion.
| Year | Uninsurance rate | Nonelderly adults without coverage |
|---|---|---|
| 2013 | 15.9% | 131,236 |
| 2014 | 14.2% | 116,691 |
| 2015 | 11.7% | 95,706 |
| 2016 | 11.6% | 94,113 |
| 2017 | 11.8% | 93,127 |
| 2018 | 11.5% | 91,304 |
| Note: Nonelderly adults were defined as 18 to 64-year-olds through 2016, and 19-64 year-olds for 2017 and 2018. Source: MECEP analysis of U.S. Census Bureau, American Community Survey data. | ||
$1.4 billion: Federal subsidies to help Mainers get covered
MECEP estimates that Mainers have received almost $1.4 billion in financial assistance to purchase health insurance since the implementation of the individual marketplace and associated premium supports.
The ACA guarantees that most Americans with low incomes will get help covering the cost of health insurance purchased through the individual marketplaces. Advanced Premium Tax Credits are available based on household income, and cap the out of pocket premium cost at a share of total income between 2 percent and 9 percent.
As of early 2019, 89 percent of Mainers enrolled in a healthcare.gov plan qualified subsidies worth $600 per month on average.
40,000: Mainers with health insurance from Medicaid expansion
The ACA allowed states to expand Medicaid to cover more residents with low incomes at a reduced cost to the state. Maine voters approved Medicaid expansion in 2017 and the policy was implemented by Gov. Janet Mills in January. As of October 25, more than 40,000 Mainers in the expanded eligibility group have received coverage through MaineCare.
