AUGUSTA – Rep. Kevin Glynn, R-South Portland, says he knows how to cut private health insurance premiums in half in Maine, and also help the uninsured afford coverage.

Glynn, backed by more than 70 House and Senate Republicans, is pushing legislation to create a “high risk” insurance pool in Maine, which would kick what he calls the “break-the-bank-people” – the sickest people – out of the normal, private market, reducing costs for everyone else.

That and several other Republican proposals, including tort reform and tax-free medical savings accounts, will be aired in public hearings today.

Gov. John Baldacci said he doesn’t support the GOP plans, and he opposes the high-risk pool out of concern the sick could go without care.

“Once you start carving out populations and do the ‘cherry picking,’ what happens is that pool of uninsured people who are going to need care is going to end up going into the emergency rooms,” Baldacci said.

If Maine allowed insurance plans to kick out the sickest, “what would happen to the older, sicker people?” Baldacci asked. “We need to recognize the impact may be good in other states, but Maine is an older, graying state and it may not be right approach.”

Baldacci said he’s met with Republicans, wants to work with them, and pledged to explore alternatives, saying, “I don’t have all the answers.”

According to Glynn, 34 other states allow high-risk pools, and that’s why their insurance costs are lower.

“We’re trying to lower the cost of health insurance in the individual market so people can buy it,” Glynn said. The Republican plan would also cut premium costs of DirigoChoice, allowing more to enroll in Dirigo, Glynn said. Now a Maine family of four pays about $1,300 a month for comprehensive private coverage. That same family pays $643 in Hartford, Conn., and $281 in Jackson, Miss., because those states have high-risk pools, Glynn said.

Maine premiums are high, he said, because a carrier “doesn’t know if you’re the person who’ll have $200 worth of medical expenses next year, or if you’re the one who breaks the bank at $100,000,” Glynn said. The sick pools would allow insurance companies to cancel coverage when someone becomes expensive, Glynn said, explaining that when carriers’ risks are less, “they can reduce their premiums dramatically.”

The legislation that Republicans back would ensure sick people continue to receive coverage “that’s just as good.” The premium of the new plan would be very high, but the costs would be subsidized by charging fees to everyone else not in the sick pool, so that the sickest would end up paying the same as before, Glynn said.

Ellen Schneiter, deputy director of the Governor’s Office on Health Policy and Finance, disagrees.

Putting the sickest in their own pool would reduce premiums for healthy people, “but it does worse than nothing for people who are ill,” Schneiter. If Maine allowed a high-risk pool, “everyone would be one day away from being uninsurable.”

She said that if she were seeking private insurance, “I’m uninsurable now,” referring to her recent bout with breast cancer. Schneiter, 49, said she’s an example of someone who might have to go into a high-risk pool. “Then I’m in a situation where they could not provide me with the same level of coverage, make me wait 12 months before they even begin to cover it.”

It could cost her “four times” the prior rate, she said. “I can’t afford that, and I make a lot of money compared to most Mainers.”

The hearings begin at 1 p.m. before the legislative Insurance and Financial Services Committee.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.