Analyses: Repealing Individual Mandate Would Leave 50,000 More Mainers Uninsured

Nov 17, 2017

About 50,000 Mainers would lose health insurance under the proposed Senate Republican tax bill, according to progressive-leaning state and national policy organizations. They say the tax bill’s provision to eliminate the Affordable Care Act’s individual mandate tugs at a thread that would significantly unravel the federal health law.

Both the Maine Center for Economic Policy and the Washington, D.C.-based Center for American Progress crunched the numbers from a Congressional Budget Office analysis to get state-specific data on the effect of repealing the individual mandate. They arrived at the same conclusion.

“Even a small state like Maine would have 50,000 more uninsured residents by 2025,” says Emily Gee, an economist at the Center for American Progress. The Maine Center for Economic Policy projected the same number of uninsured by 2027.

Analyst James Myall says that assumes Maine will expand Medicaid. If the state doesn’t, the number of uninsured will be even higher. Those hardest hit, he says, are middle class Mainers who don’t qualify for subsidies on the ACA marketplace or only qualify for small subsidies.

“The worst-hit folks are people who live in rural parts of the state, in western Maine or The County, or Down East, because that’s where premiums are already high,” he says.

If the individual mandate is repealed, Myall says younger, healthier people will likely opt out of buying health insurance. That will leave older, sicker consumers in the marketplace. To cover the cost of their care, insurance companies will likely raise premiums.

The Center for American Progress estimates the average marketplace premium for a family in Maine will increase about $2,300. Steve Butterfield of Consumers for Affordable Health Care says that will wipe out any benefit the tax bill might provide middle class families.

“That is not a path to any kind of solution except causing chaos,” he says.

Myall says plucking out the individual mandate from the ACA may seem like an easy way to reduce costs to help fund the tax bill. But he says unraveling the mandate will bring hidden costs. Hospitals will see a rise in uncompensated care, and sicker employees will find it difficult to work.

“What it really means is undermining the whole system and making the insurance market and ultimately public health in Maine worse for everyone,” he says.

Republican U.S. Sen. Susan Collins of Maine expressed concern earlier this week that repealing the individual mandate would increase premiums, though she has not announced whether she’ll vote for or against the tax bill.

This story was originally published Nov. 16, 2017 at 4:50 p.m. ET.