Aiming to assist small businesses, Maine will merge public medical insurance markets


The federal government has approved Maine’s plan to enhance medical insurance for small businesses through a change in the best way the state offers coverage through the federal Reasonably priced Care Act, also often called Obamacare.

Maine plans to merge individual and small group coverage markets right into a single, pooled market starting in 2023. State officials imagine the change will stabilize the medical insurance market, and can extend federal funding through the Maine Guaranteed Access Reinsurance Association — which has stabilized Maine’s individual market since 2019 — to the small group marketplace for the primary time. 

The plan requires a state innovation waiver from the U.S. Centers for Medicare and Medicaid Services, which last week notified the Maine Bureau of Insurance that its waiver request was approved.

Medical insurance premiums are rising in Maine for 2023, as they’re across the county. However the state said the federal waiver will end in premiums which are on average 8% lower in the person market and 6% lower within the small group market.

The change is projected to reverse the trend of high premium increases and declining enrollment within the small group market while continuing to limit price increases in the person market.  

For instance, a 40-year-old with a typical small group coverage might have paid $44.02 more every month in 2023, but with the waiver the premium increase will probably be $15.92, in keeping with a news release.

The person market serves individuals who buy insurance on their very own with federal financial assistance while the small group market serves employers with 50 or fewer staff. 

Maine is the primary state within the nation under the Reasonably priced Care Act’s 1332 waiver program to supply federally supported reinsurance to each small employers and individuals. This system, supported by federal funding and costs on health insurers, pays for a part of the price of the costliest health bills, lowering and stabilizing medical insurance premiums.

The waiver request was included Gov. Janet Mills’ bipartisan health reform laws, the Made for Maine Health Coverage Act. 

“Small businesses are the backbone of Maine’s economy, providing jobs and crucial advantages like medical insurance to tens of hundreds of Maine people,” Mills said. “Ensuring that medical insurance stays inexpensive is critical, not just for the health of small businesses but for the health of their employees as well.”


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