AUGUSTA — After several weeks of bitter partisan rancor and maneuvering, the Maine Senate Monday passed a bill containing sweeping changes to the state's health insurance laws.
The 24-10 vote broke mostly on party lines with three Democrats voting to support the GOP bill. The legislation essentially repeals and rewrites most of Maine's insurance laws and adds language that allows out-of-state insurance providers to sell plans here.
The interstate insurance provision has long been sought by Republicans who have argued that it will add competition and drive down rates.
Democrats counter the new legislation removes many current consumer protections, including regulations that prevent insurance companies from charging higher rates to Mainers in rural areas.
The bill is modeled after Idaho's insurance law in place since 2001. Republicans say that state's law is proof that Maine was taking a step in the right direction.
Sen. Jonathan Courtney, R-Springvale, said the bill would lower insurance rates and send a positive signal to the business community.
"It's about changing the environment for job creation," Courtney said.
Senate President Kevin Raye, R-Perry, said the plan protected rural residents and Mainers with pre-existing conditions.
"The status quo has resulted in too many Mainers losing insurance coverage and thousands of others threatened with that loss," Raye said in news release. "The bill we sent to the governor today offers hope by injecting competition and choice into the system."
Democrats weren't convinced.
Sen. Margaret Craven, D-Lewiston, quoted a member of the Idaho chapter of the AARP, who said he couldn't "understand why anyone would hold up Idaho as a model for health care."
Elizabeth Schneider, D-Orono, was one of three Democrats who voted with the Republican majority. Schneider said that her support came despite "grave" concerns about its impacts.
Sen. Nancy Sullivan, D-Biddeford, and Sen. Bill Diamond, D-Windham, were the other two Democrats who voted with the GOP.
During the floor debate Sullivan acknowledged that her vote wouldn't be popular with fellow Democrats, saying she felt like "a woman without a party."
Democrats have fiercely resisted the legislation, arguing that the GOP's decision to fast-track the bill was reckless. They also argued that the bill was a boon to insurance companies.
Those points were raised by Sen. Phillip Bartlett, D-Gorham, who said that Anthem, the state's largest insurer, was pushing the bill. He argued that the company would put profits over health care for Mainers.
Anthem has not taken a formal position on the bill. It testified neutrally during an April 27 public hearing on the proposal. However, the company was consulted during the re-drafting of the legislation, as were other organizations like the Maine Heritage Policy Center, a conservative advocacy group.
On Monday Democrats underscored their concerns about the alacrity of the bill, which has gone from public hearing to enactment in 20 days.
Republicans began expediting the bill two weeks ago when it added a 29-page amendment to a four-page bill that originally sought changes in community rating. The legislation passed Monday is 45 pages.
Democrats claimed the bill was "ramrodded" through the Legislature. During floor debates in the House and Senate several Democrats attempted to amend the law to fix what they view as reckless provisions that will empower insurance companies at the expense of older and rural Mainers.
"What's it going to do for your constituents and mine?" Bartlett asked. "We don’t know. ... The bottom line is this bill is not ready for enactment."
Republicans have defended the process, but they have thus far been unable to win the unilateral support of traditional allies.
The Maine Chamber of Commerce, which has supported efforts to reform the state's insurance laws, has said it would be closely monitoring potentially harmful provisions.
The National Federation of Independent Business has also expressed reluctance to support the legislation without a detailed analysis of its impacts.
NFIB mostly represents businesses with fewer than 50 employees. The group has supported interstate insurance sales, a key component of LD 1333. The group also supports repeal of the individual mandate in the federal health care law.
On Monday Democrats acknowledged that health insurance costs were too high in Maine. However, they said Republicans' were unwilling to consider amendments.
"I don't feel comfortable going forward on hope," said Sen. Seth Goodall, D-Richmond, adding that the legislation lacked independent analysis from the Bureau of Insurance.
On Monday, Mila Kofman, the superintendent of the BOI, resigned her post.
The following are key provisions of the bill:
* A change in rate structure that gives health insurance companies more freedom to charge higher rates to Mainers who are older, sicker and live in rural areas.
* The creation of a Guaranteed Reinsurance Plan, also referred to as a "high-risk pool," to cover sicker or older Mainers who frequently seek health care services.
* The repeal of a rule that protects Mainers from having to travel more than 30 minutes from their home for primary care and more than 60 minutes for hospital services.
* The marketing of out-of-state insurance plans in Maine, as well as the banding together of certain businesses to form insurance-buying groups.
* The repeal of the state's biannual assessment of health care facilities and services available in Maine, aimed at ensuring cost-effective investment and development.
* Several provisions that may conflict with the rollout of the Affordable Care Act national health reform in Maine, including one that limits the coverage of children 26 and under on their parents' health insurance to those dependents who reside in Maine. The state attorney general last week ruled that the bill "appears to be consistent" with the ACA.
Gov. Paul LePage is expected to sign the bill Tuesday during a public ceremony with GOP leadership.