The Obamacare Maine state exchange is run by the federal government. This is because Maine’s government has opted out of running their own exchange. So, the Federal government runs the Obamacare Maine exchange for them.
The healthcare marketplace in Maine is responsible for signing up the people who lack healthcare insurance. The Obamacare Maine exchange is a place where private health insurance polices–that have met Affordable Care Act regulations–can be purchased.
Maine is one of 36 states that will let the Federal government run their healthcare marketplace. The Obamacare Maine state exchange for Maine residents can be found at: Healthcare.gov.
Here is Sen. Susan Collins (R) reading her viewpoint about Obamacare and small business:
For a 27 year old (cheapest age) the weighted average in Portland, ME (monthly premiums before federal tax credits) is:
- Cheapest Bronze plan costs $192
- Cheapest Silver plan costs $233
- Cheapest Gold plan costs $306
- Cheapest catastrophic plan (under 30) is $162.
The Maine healthcare exchange is simply a store where you can compare/buy Obamacare plans. 85% of Americans already have insurance, and have little need for the healthcare exchange (other than to shop for a cheaper plan). 15% of Americans don’t have insurance. These are the ones who really need to use the healthcare exchange to get coverage.
How Do I Sign Up For Obamacare In Maine
How do I sign up for Obamacare in Maine?
Sign up for Maine Obamacare by going to Healthcare.gov. You can get healthcare on the Obamacare Maine state exchange 3 ways:
- by mail
- in person
Calling 800-318-2596 (TTY: 1-855-889-4325) is the phone number for individual Obamacare help. Small business can call 800-706-7893 (800-706-7915). You can go Find Local Obamacare help here.
Open enrollment begins October 1st of each year. Healthcare coverage begins January 1st. You must apply for healthcare via open enrollment by March 31st. You must have health coverage or pay a penalty due to the Individual Mandate. By applying for coverage, you will find out if you qualify for:
- Subsidized Private Insurance Plan
- Private Insurance Plan (likely cheaper premiums than private offerings)
Obamacare For Maine Residents
Obamacare for Maine residents can be bought at Healthcare.gov. You can go there to see what plans you qualify for, and how much they cost. Maine residents with lower incomes are eligible for subsidies or Medicaid.
Do I Need To Sign Up For Obamacare?
To answer the question, “Do I need to sign up for Obamacare?” consider the following:
- If you like the insurance you currently have through your employer or government, you don’t have to do anything. You can shop for cheaper insurance by applying on the state marketplace.
- If you don’t have insurance–and you are low income ($15,282 for an individual)–you may qualify for the expansion of Medicaid.
- If you don’t qualify for Medicaid, you will likely qualify for subsidies to buy health insurance when you sign up on the state exchange at Healthcare.gov.
Obamacare Maine Rates
Obamacare Maine rates vary by the same factors that exist in most states. In Maine, the rate you pay for health insurance varies by:
- your age
- your income
- where you live in Maine
- if you smoke
- the level of coverage you pick
Federal tax credits will help people with low to mid incomes pay for heath insurance. Obamacare Maine tax credits are the same as in other states. The only difference is how the poverty level is defined in each state.
Maine rates are also determined by insurance companies who divide Maine into regions when setting the rates. Maine rates are coming in higher than expected.
Maine Waiver: Higher Rates
Maine gave insurance companies a waiver that will result in higher rates. Maine insurance companies successfully threatened that they would exit the state if they did not get a Maine waiver. So, the Maine government gave them a waiver from Obamacare.
The waiver allows insurance companies to ignore the Obamacare clause that says 80% of premiums must go to actual healthcare costs. The result is that insurance companies are free to profit more from Maine residents, than they are in other states. The differences between high and low rates for healthcare insurance in each region includes:
- regional differences in medial costs
- relative health and age of the population
- disease/mortality rates of the region
- competition between insurers
- (more insurers leads to lower rates)
Maine premiums for insurance are coming in lower than expected. The best way to get lower premiums is to qualify for Medicaid. The next best way is to qualify for Federal subsides by falling into the income ranges below.
Subsidies on Maine premiums are for individuals and families who make between:
- $11,490 to $45,960 for individuals
- $15,510 to $62,040 for a family of 2
- $19,530 to $78,120 for a family of 3
- $23,550 to $94,200 for a family of 4
- $27,570 to $110,280 for a family of 5
- $31,590 to $126,360 for a family of 6
- $35,610 to $142,440 for a family of 7
- $39,630 to $158,520 for a family of 8
Individuals and families that make less than this range may be eligible for the expansion of Medicaid (detailed below). Those that make more than this range are not eligible for Federal subsidies, but should still be able to find cheaper plans than in the private sector.
Those that do fall into this range will get Federal subsidies on their health insurance. Obamacare Maine premiums also depend on the type of plan you choose. See more about Obamacare plans here. Recent data from the RAND Corporation on Maine premiums shows that in Maine (before Federal subsidies):
For all age groups and plans combined in Maine:
- The Lowest Cost Weighted Average Premium (Bronze) in Maine is $328/month (national average is $249).
- The Lowest Cost Weighted Average Premium (Silver) in Maine is $388/month. (national average is $310).
- The 2nd Lowest Cost Weighted Average Premium (Silver) in Maine is $403/month. (national average is $328).
For a 27 year old (cheapest age) weighted average in Maine (monthly premiums) before federal tax credits:
- The cheapest Bronze plan costs $216
- The cheapest Silver plan costs $255
- The cheapest Gold plan costs $336
- The cheapest catastrophic plan (under 30) is $182.
For a family of 4 ($50,000 income) weighted average in Maine (monthly premiums):
- The cheapest Bronze plan costs $104/monthly after tax credits
- The 2nd cheapest Silver plan costs $961/month before tax credits
- The 2nd cheapest Silver plan costs $282/month after tax credits
These premiums are for weighted averages for most people. Results will vary based on a few factors for your personal situation. The bad news about Maine premiums is that they are much higher than the national average. Insurance companies are making up for the fact that they could exclude people with preexisting conditions in the past.
The good news about Maine premiums is that Federal subsidies will help lower costs for many people. Individuals making less than $45,960 are eligible for subsides in Maine. Families of four making less than $94,200 should also qualify for subsidies on premiums.
Medicaid Expansion In Maine
Medicaid expansion in Maine is not going to happen at this time. Under Obamacare, people making less than $15,282 (133% of Federal Poverty Line) should qualify for the Medicaid expansion.
Gov. Paul LePage has called the IRS the new Gestapo. LePage says he is against Medicaid expansion in Maine because it is a “degradation of our nation’s premier health care system. Here is Gov. Paul LePage talking about Obamacare:
We are promoting entitlement programs that are breaking the bank…Government run healthcare is not what the American Dream is about. Democrats are attacking Republican saying that they are turning down free healthcare. I have always said that it doesn’t matter if money is being taken from the Left pocket or the Right pocket…it is still my pocket.
The Legislature created a bill that would expand Medicaid in Maine. But, Gov. LePage vetoed the bill. He has decided not to expand Medicaid at this time. The failure to expand Medicaid is likely to make residents in Maine angry. The worst part is that someone:
- Making $25,000/year will pay half as much insurance as someone making $10,000/year.
- At $25,000/year, you qualify for Federal subsidies that reduce your rates.
- At $10,000/year, you should qualify for Medicaid and have free insurance.
- The failure to expand Medicaid means people making $10,000 will have to buy insurance without any subsides.
You have to make between 133% and 400% of the Federal Poverty Line to be eligible for subsidies. Those making less are supposed to get Medicaid. Because people making less than the poverty line don’t get Medicaid in Maine, they are effectively locked out of getting health insurance.
The irony is that the people Obamacare was supposed to help the most, are getting helped the least.
Although all of this may sound complicated, what you have to do is sign up at Healthcare.gov. The Obamacare exchange in Maine will help you see what Obamacare can do for you.