Maine’s health insurance panel composed almost entirely of industry members

AUGUSTA, Maine — With one notable exception, a new nine-member committee charged with developing Maine’s federally mandated health insurance exchange is made up almost entirely of health care and insurance insiders.

The stand-out appointee is Jamie Bissonnette Lewey of Pembroke, chairwoman of the Maine Indian Tribal-State Commission. Lewey is a longtime advocate for criminal justice and health care equity. She is a member of the Abenaki Indian Tribe and is married to Newell Lewey, a member of the tribal council for the Passamaquoddy Tribe at Pleasant Point.

Committee chairman Joe Bruno of Raymond, a former Republican state legislator, owner of a southern Maine pharmacy group, and board member of the Dirigo Health Agency, says the industry-weighted board appointed by Gov. Paul LePage is well positioned to tackle the job of building Maine’s insurance exchange.

“Our role is technical in nature,” Bruno said on Wednesday. “We’ll be looking at the building and integration of the system, not looking at policy at all, really. We’re trying to keep it apolitical.”

But for a project that aims to protect members of the public as they shop for health insurance coverage — which will be required of virtually all Americans by the beginning of 2014 — the makeup of the advisory panel presents some concerns to Maine’s leading consumer health advocacy organization, Consumers for Affordable Health Care.

“We feel all the people appointed have a lot to offer,” said CAHC policy director Mitchell Stein on Wednesday. In particular, he noted, his organization appreciates the inclusion of Lewey, whom he called “a great advocate for tribal interests.” Stein said the CAHC offered to serve on the committee but was rejected, although he stressed LePage’s office has been “gracious” throughout the process.

Nevertheless, Stein said he remains concerned there is not enough of a consumer voice on the panel to guard against conflicts of interest and to ensure the goals of the exchange are adequately met, as set forth in the federal Affordable Care Act.

In addition to Lewey and Bruno, the committee includes:

Dan McCormack, CEO, Intermed

Steve Michaud, president, Maine Hospital Association

Kristine Ossenfort, director of government relations, Anthem Blue Cross Blue Shield of Maine

Joel Allumbaugh, CEO, National Worksite Benefit Group and health policy director, Maine Heritage Policy Center

Dan Bernier, insurance lobbyist

Edward Kane, vice president for Maine, Harvard Pilgrim Health Care

David R. Clough, Maine State Director, National Federation of Independent Businesses

The health insurance exchange is intended to be a mechanism by which people looking to purchase health insurance can readily compare costs and coverage plans offered by competing private insurance companies. The exchange also must help consumers determine their eligibility for Medicaid and other public coverage as well as their eligibility for subsidies that offset the cost of private insurance. The exchange is envisioned primarily as an online resource, but it also must include designated “navigators” — individuals or organizations that help consumers get the information they need.

Stein said states have been granted a degree of flexibility in how their exchanges are designed and in the makeup of their boards. But board members and navigators should represent a range of expertise, he said, including public coverage programs and subsidy design as well as private insurance plans. In addition, Stein said, the exchange should not be designed with “anti-incentives” that might discourage consumers from applying for public plans or subsidies.

“If this is weighted too far toward industry … it could be problematic,” Stein said.

He added that Consumers for Affordable Health Care looks forward to participating in an “open and transparent process” as the committee does its work.

Lewey said on Wednesday that she has been contacted by a number of consumer advocacy groups since the committee list was released earlier this week. While her first duty is to ensure Maine tribes have an opportunity to participate in the exchange design, Lewey said the exchange must be structured to serve all Maine people fairly, including tribal members, rural residents, immigrants and “all minority and marginalized populations.”

Lewey said she is prepared to stand up for all Mainers, but assumes she is not alone in her interests.

“I realize I am the only person on this board not connected to industry, but that doesn’t mean I’m the only person on this board to represent the consumer,” she said. “I like to think we all do that.”

The committee is scheduled to make recommendations to the Legislature on or before Sept. 1. Bruno said that timeline may need to be extended given the complexity of the task and the fact that federal guidelines have not been finalized. By federal statute, the exchange must be up and running by September 2013.

A Massachusetts-based consultant has been retained to help the committee with its work, Bruno said, and the Dirigo Health Agency may be restructured to house and administer the new exchange. Maine already has received a $1 million federal grant to help with the design and implementation of the exchange and will apply for a second grant in coming weeks, he said.

All meetings of the new advisory committee are open to the public. The first meeting will be held from 9:30 a.m. to noon Tuesday, Aug. 16 at the Dirigo Health Agency offices on Water Street in Augusta.

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Ed Enos's picture

Misleading headline perhaps?

Let's see, 2 healthcare reps, 1 pharmacy rep, 1 health care advocate, 2 insurance company reps, 1 lobbyist, 1 business rep and Allumbaugh, don't know what he represents. Seems like a pretty balanced committee with reps present to advocate for patient care, and cost containment.

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