The first bill to be presented by incoming legislative leaders and Gov.-elect Janet Mills will aim to protect parts of the federal Affordable Care Act that have been ruled unconstitutional by a federal judge in Texas, Democratic leaders announced Monday.
That ruling, which is being appealed, would eliminate the requirement for health insurance companies to provide coverage to people with pre-existing medical conditions, among other key tenets of the Affordable Care Act.
Mills and the leaders of the Democratic majorities in the Maine House and Senate said Monday that the first piece of legislation they will take up is “An Act to Protect Health Care Coverage for Maine Families” or L.D. 1.
Among other things, the legislation would make it clear that patients with pre-existing conditions cannot be denied coverage. It also would allow children to remain on a parent’s health insurance coverage to the age of 26 and would prohibit any lifetime limits on coverage, provisions that also are part of the federal law.
“I refuse to stand idly by as forces in Washington and elsewhere work to strip Maine people of critical coverage for pre-existing conditions and other essential health benefits like mental health and maternity and newborn care,” Mills said in a prepared statement announcing the bill Monday. “Maine can do more to strengthen its laws and align them with the protections guaranteed under the Affordable Care Act. That’s why my administration will move immediately, in concert with the Legislature, to help protect Mainers with pre-existing conditions, regardless of what happens at the federal level.”
Senate Minority Leader Dana Dow, a Republican from Waldoboro, said most Republicans in Maine and on a national level generally support preservation of health care coverage for people with pre-existing conditions, but he declined to comment further on L.D.1.
Dow said he will reserve judgment on whether he thinks it is a good idea until he has had more time to review the proposed legislation.
Senate President Troy Jackson, D-Allagash, presented similar legislation in 2018 that was passed by the Legislature but was vetoed by Republican Gov. Paul LePage, whose term ends Wednesday.
“With health care increasingly under attack, it’s our job as state lawmakers to do everything in our power to protect the health and well-being of Maine people, starting with this legislation,” Jackson said Monday, calling health care a basic human right. “We must also work together to lower health care costs, increase access to care and strengthen the quality of coverage.”
House Speaker Sara Gideon, D-Freeport, joined Jackson and Mills in voicing support for the legislation.
“Our goal is affordable and accessible health care for every Maine family. From the closings of many of our rural hospitals to the outrageous cost of prescription drugs to a crippling opioid epidemic, the problems are real and they are staggering,” Gideon said. “This lack of access is causing lasting damage to not just individuals, but to our entire economy and it is time we took action.”
Though the ACA remains in effect while U.S. District Court Judge Reed O’Connor’s ruling is being appealed, Maine Democrats said they do not want to take any chances and are replicating in state law provisions of the federal law to protect health care consumers.
About 230,000 Mainers under age 65 have a pre-existing condition, according to the Kaiser Family Foundation.
A pre-existing condition can be any condition that an enrollee knew about prior to signing up for insurance. Under federal changes made last fall that allow the sale of low-cost policies, health insurance companies that sell those plans and discover that a patient had a pre-existing condition before enrolling can legally deny claims. A pre-existing condition could be something as serious as cancer or as treatable as high blood pressure or a nut allergy.
However, Maine Sen. Susan Collins, a Republican, has said Maine law already provides some protection for people with pre-existing conditions. Collins declined to join other U.S. senators, including Sen. Angus King, a Maine independent, when they urged President Trump to condemn the court ruling.
In a statement dated Dec. 19, Collins said O’Connor’s ruling was “far too sweeping” and is likely to be overturned on appeal.
Language in the Democrats’ bill says: “Recent court decisions may endanger important consumer protections related to health insurance coverage in the federal Patient Protection and Affordable Care Act, including pre-existing condition exclusions, essential health benefits, and annual and lifetime limits on the dollar value of benefits. The purpose of this legislation is to ensure that those consumer protections are codified in state law.”
Mitchell Stein, a Brunswick-based health policy consultant, commended Mills for coming up with what he described as a “backup protection plan” in the event that O’Connor’s ruling is upheld.
Stein said L.D. 1 would kick in to provide coverage to Mainers with pre-existing conditions if the Affordable Care Act is ruled unconstitutional, something Stein says is highly unlikely.
“All I can say is that I applaud Janet Mills for the effort. It will preserve the baseline of health care for Mainers. This (bill) is a very specific response to the court case in Texas,” Stein said. “L.D. 1 is protection against the distant chance that the Texas ruling is victorious.”
Stein reviewed a copy of the proposed law Monday night and pointed out that it is not clear whether the legislation would protect Mainers who purchased short-term health care plans. He said those plans sometimes exclude coverage for persons with pre-existing conditions – in his opinion a shortcoming in existing state law.
Before the Affordable Care Act became law, denials based on pre-existing conditions were one of the more common reasons people would file for medical bankruptcy.
L.D. 1 will be subject to public hearings before the Legislature’s Health Care Insurance and Financial Services Committee. The 129th session of the Maine Legislature will begin in earnest Wednesday evening when Mills is sworn in as governor.
Staff Writer Dennis Hoey contributed to this report.
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