Congress must expand the advances in health insurance that are vital to Mainers and millions of Americans

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Ann Woloson is executive director of Consumers for Affordable Health Care. Julia Underwood is the associate director of the group that serves as Maine’s health insurance consumer assistance program.

Great news! The US Department of Health and Human Services announced last week that the number of uninsured adults ages 19 to 64 hit an all-time low. Congress must act soon, however, or 13 million Americans’ monthly health insurance premiums will increase over the next year, slightly reversing that trend.

Phillip, who lives in Penobscot County, is one of the people who received coverage. He works for a small car company and is in excellent health. However, in order to stay healthy and able to work, he must take an expensive prescription drug and see his doctor regularly. His health insurance makes it possible.

Philip and other Mainers like him are benefiting from recent policy changes that have reduced the number of uninsured. These changes include access to coverage through the Medicaid Amendment to the Affordable Care Act and temporarily increased subsidies for Marketplace plans made available through the American Rescue Plan, passed by Congress last year.

When Gov. Janet Mills implemented the will of the people of Maine by expanding Medicaid, she could not have foreseen how important the decision would become. First, it has helped many people access the coverage and health care they need on a daily basis. In Maine, the uninsured rate for the state’s low-income residents fell nearly 5 percentage points.

Second, it helped thousands of Mainers who had lost employer-based coverage due to the pandemic. With over 95,000 Mainers enrolled in the MaineCare Extension, it remains a critical means of accessing healthcare as Mainers adjust to the new normal of the pandemic, return to the workplace, and cope with the uncertain economy.

In addition, the Mills administration has made other investments to help Mainers register for cover, including transitioning to a state exchange, CoverMe.gov, where Mainers can register for cover and increase outreach and education about cover options . These are part of a multifaceted strategy that has helped successfully reduce our state’s unemployment rate.

At the federal level, the American Rescue Plan provided increased subsidies to help Americans pay their monthly health insurance premiums. These subsidies have helped make private health insurance more affordable for millions of Americans, including nearly 66,000 Mainers who purchased private Marketplace insurance this year.

Without these improved subsidies, states would have experienced a premium increase of 53 percent on average. Instead, Maine’s premiums fell an average of 13 percent. As affordability improved in 2022, thousands more Mainers purchased custom marketplace coverage (an 11 percent increase from 2021). The self-employed and small business owners and their employees account for more than half of the marketplace participants and thus benefit from the increased subsidies.

The Inflation Reduction Act would extend the increased subsidies by a further three years from 2023. It would also limit Medicare Part D prescription drug co-payments to $2,000 annually and provide a way to negotiate certain Medicare prescription drug prices, giving seniors a huge boost to fixed income. With prescription drug price reforms supported by about three out of four voters, it’s exciting to see policymakers taking these important steps to curb drug costs. If passed, the package would provide a basis for future action to address both rising health insurance and prescription drug costs.

For Phillip of Penobscot County and many other Mainers, the Inflation Reduction Act is vital. Being able to see his doctor and get the medication he needs to stay healthy and work will make all the difference in his life. Now more than ever, action to reduce healthcare and prescription drug costs in America is imperative.

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