How can Maine keep Obamacare subsidies no matter what Supreme Court does?

Screen Shot 2013-12-19 at 9.57.41 PMAre over 60,000 Mainers at risk of losing subsidies for buying private health insurance?

Yes, but the Maine Legislature could make sure those subsidies continue.

By Monday morning, we’ll know if the Supreme Court rules that people buying health insurance through a federal exchange can continue to get subsidies.

If the Court says no, this decision would also have an impact on health insurance costs throughout the state, raising premiums for many more.

But, while a good deal of attention has been on what Congress will do should the Court rule for the plaintiff, Congress isn’t the only body that can do something about this for Mainers.

Maine can set up a state run insurance exchange.

There is no question by anyone that subsidies are available for people buying insurance through a state exchange.

What’s more, the Maine Legislature already has a bill that’s been passed by the House, and by a veto-proof majority of 106-23. The Senate has tabled the bill, but it could be taken up before the end of the session if needed.

Of course, given that the governor has said he’d veto pretty much everything, a veto would most likely be forthcoming.

But this bill could be passed and would allow for the continuation of the very popular subsidies for Mainers.

There may be a low cost way of implementing it, by contracting with the federal government to run the state exchange.

By the way, Pennsylvania and Delaware “have been ‘conditionally approved’ to set up their own healthcare marketplaces, the Centers for Medicare and Medicaid Services (CMS) announced” last week, which would be created this year should federal exchange subsidies no longer be available. Arkansas also received approval to create such an exchange in 2017.

Should this become a live issue, it’s very likely that we’ll reminded about how Republicans who opposed Medicaid expansion in Maine said expansion wasn’t necessary because a good chunk of those who would be covered could get coverage through the exchange.

That wouldn’t be possible if the Court rules for the plaintiff in King v Burwell and if the Legislature doesn’t create a state exchange. If they didn’t, 61,000 or so Mainers would pay the price.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.