By: Maine Center for Economic Policy (MECEP)
Authors: James Myall, Policy Analyst
Published: December 2019
Commissioned by: Maine AllCare
Legislation analyzed: No legislation analyzed, a new plan is proposed in the paper.
Download the Report: from the Maine Legislature or below.
The plan outlined in this report would leave federal programs intact and provide a state-run program to cover the remainder of the population, including those who are currently uninsured or covered by private insurance. It features the following characteristics, which undergird the figures and statistics found throughout this report:
- Mainers enrolled in existing public programs would keep their coverage. The state would fund initiatives to fill coverage gaps and eliminate out-of-pocket costs for this group.
- Mainers currently enrolled in private plans and those who are uninsured would be enrolled in a publicly funded program modeled on Medicaid. MECEP assumed mandatory enrollment, to preserve cost-savings and capture greater efficiency in the overall health care system.
- Enrollees in the publicly funded program would pay a coverage fee or tax that would be capped as a share of income. There would be no copays, coinsurance, or deductibles, and care would be free at the point of service.
- Reimbursement rates for providers within the state program would increase to match
current Medicare rates.
Based on these assumptions, approximately 652,000 individuals, including 74,000 currently uninsured individuals, would obtain coverage through the new program. Net program costs are projected at $4.9 billion once federal subsidies and state-level savings are accounted for. Approximately 80 percent of these costs would be paid in the form of individual and employer taxes that would recapture funds currently being spent on premiums, deductibles, and out-of-pocket costs. The remainder — about $1 billion — would need to be paid for by raising taxes. In this report, MECEP has included several potential revenue sources.