Gov. Mills, Commissioner Lambrew Announce Federal Approval of Maine State-Based Health Insurance Marketplace

AUGUSTA, Maine, Oct. 5 -- Gov. Janet Mills, D-Maine, issued the following joint news release on Oct. 4, 2021:

Governor Janet Mills and Department of Health and Human Services (DHHS) Commissioner Jeanne Lambrew announced today that Maine's State-based Health Insurance Marketplace (SBM) has been approved by the Federal government, allowing Maine to run the online health insurance market to make it easier and more convenient for Maine people to get affordable, quality health insurance coverage.

Individuals and families will be able to use the Marketplace, called CoverME.gov, beginning November 1, 2021 to explore health plan options, shop, and enroll in private insurance, with most people qualifying for Federal financial assistance to make premiums more affordable. Since additional financial assistance was authorized by the American Rescue Plan Act earlier this year, nearly 25 percent of consumers in Maine have enrolled in a Marketplace plan in 2021 with a monthly premium of $10 or less.

"My Administration is committed to ensuring that Maine people can see their doctor, receive care, afford their medications, stay healthy, and contribute to our state. That's why we expanded MaineCare to 85,000 people and why, now, we're taking another important step forward in ensuring access to affordable health care by transitioning to a fully state-run Marketplace," said Governor Mills. "The CoverME.gov State-based Marketplace will help Maine people get the health care they need in 2022, and we thank the U.S. Centers for Medicare and Medicaid Services for its continued support."

"Federal approval means Maine can capture funding currently going to Washington, D.C. and use it to customize the enrollment process to fit our state's needs," said Jeanne Lambrew, Commissioner of the Maine Department of Health and Human Services. "The CoverME.gov Marketplace will give Maine people better access to affordable health insurance options when open enrollment kicks off on November 1."

The State-Based Marketplace is central to the Mills Administration's work to improve access to affordable health care. In addition to expanding access to MaineCare for more than 85,000 Maine people, Governor Mills' Made for Maine Health Coverage Act authorizes the Department to run a State-based Health Insurance Marketplace and makes some of the most common medical visits free or less costly, as part of a larger plan to improve private health insurance for Maine people and small businesses.

"The Mills Administration's plan to fully operate Maine's health insurance Marketplace won broad, bipartisan support in the Legislature because it will improve access to high-quality, affordable health care through a system tailored for Maine people," said Senator Heather Sanborn and Representative Denise Tepler, chairs of the Legislature's Health Coverage, Insurance and Financial Services committee. "We were proud to support this effort and welcome this federal approval as we look forward to the Marketplace's launch in November."

The approval from the U.S. Centers for Medicare & Medicaid Services earned praise from several stakeholders in Maine, who welcomed it as a victory for Maine health care consumers:

"This Federal approval is welcome news for consumers in Maine, who will have access to new tools built specifically to help them choose the plan that best fits their needs and budget," said Ann Woloson, Executive Director of Consumers for Affordable Health Care. "We look forward to working with the Department to continue to make the process of applying for and enrolling in quality coverage easier for Maine people."

"We are excited about the roll out of the Maine Marketplace," said Kimberly Vance, President of the Maine Association of Health Underwriters, the leading trade organization in the State representing health insurance brokers and agents. "We think that by being in control of the entire process, from outreach to enrollment, Maine is taking an important step in providing consistency and certainty for the citizens of Maine who rely on the insurance they obtain through the Marketplace."

"The state-run Marketplace is one of the most important steps Maine has taken in providing individuals a strong avenue to gain coverage and, thereby, remove one barrier to seeking care," said Barbara Leonard, President and CEO of the Maine Health Access Foundation. "It is also an important milestone in the continued journey toward equitable care for all people in Maine."

The Department of Health and Human Services took the first step in the transition to a State-based Marketplace during the 2021 Open Enrollment Period (from November 1, 2020 to December 15, 2020), by launching a hybrid Federal-State Marketplace, following Maine's use of a fully Federal system since 2014. The hybrid Federal-State Marketplace allowed the State to assume greater responsibility for some Marketplace functions, such as marketing, outreach, and consumer assistance, while continuing to use the Federal HealthCare.gov platform to process applications, determine eligibility, and enroll participants.

For the 2022 open enrollment period that runs November 1, 2021 to January 15, 2022 and in future years, CoverME.gov will serve as Maine's fully state-based marketplace platform. The Department launched the website in October 2019 as a resource for Maine people to explore affordable health insurance options. With the new State-based Marketplace, CoverME.gov will expand to become the official platform where Maine people can shop for and enroll in private coverage. This fall, the Department plans to launch a marketing campaign to raise awareness of the transition and Maine consumers' options for coverage through the State-based Marketplace. In mid-October, Maine residents will be able to see the plan options for 2022 on CoverME.gov so they can begin thinking about their options.

Currently, 15 other states run a State-based Marketplace, including all other New England states except New Hampshire. The ongoing operation of Maine's State-based Marketplace is funded by a user fee charged to health insurance companies that use the platform to sell their plans.

As in previous years, those who already have a Marketplace plan will be automatically re-enrolled in their current plan or the most similar offering from their health insurance carrier. Consumers will receive information about the re-enrollment process directly from CoverME.gov in October. People who apply through CoverME.gov who are eligible for MaineCare will have their application sent to MaineCare for review. Eligible Maine people can enroll in MaineCare at any time of year.