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With ACA Repeal Looming, Maine’s Delegation Debates Replacement Program

The Republican-controlled Congress has taken the first steps in a complex process aimed at repealing the Affordable Care Act and replacing it with a new health insurance program. Maine’s congressional delegation is unified around the need for that replacement program, but have different views on what it should look like.

Congress is taking scores of votes as it uses a parliamentary tactic to carry out the repeal process. The goal for Republicans is to position the votes to only need a majority in each branch to pass the legislation, and avoid the 60-vote threshold required to overcome a Senate filibuster.

Republican U.S. Sen. Susan Collins voted for the process, independent U.S. Sen. Angus King opposed it.

“We’re talking about something like 80,000 people in Maine whose insurance coverage is at risk, 15 or 20 million nationwide. The impact could be huge,” he says.

King points out that it took two years for insurers to implement the ACA, and believes it could take as long to implement a replacement plan. He worries that could lead to a gap in coverage.

Collins says she too wants to make sure that the replacement plan is in place before Obamacare is repealed.

“That has been my position for a very long time. We do have to make sure there is a system in place that takes care of individuals that are receiving subsidies,” she says.

Both senators agree that any replacement plan must prevent insurers from disqualifying consumers because of pre-existing conditions or capping benefits. And they want to protect the ACA provision that allows young adults to continue on their parents’ insurance policy until age 26.

Collins says the new plan should also address the problem of benefit cliffs, in which insured people lose their premium subsidies because of even a tiny increase in income.

“The basic subsidy for your premium goes up to 400 percent of the poverty rate, but if you make a dollar more, you lose the entire subsidy,” she says.

Collins says she also wants to see provisions aimed at containing the costs of health care, which she says would help all Americans.

Beyond the changes to the ACA, King says he’s also concerned that some Republican House members will also try to restructure the Medicare program and introduce a voucher system that he says would shift more health care costs to seniors.

“If they do that, I think they may end up losing the whole thing, because that is just not a good idea,” he says. “I don’t think anybody but this small group of ideologues in the House thinks it’s a good idea.”

U.S. Rep. Chellie Pingree, a Democrat from Maine’s 1st District, says with more and more Americans signing up for the Affordable Care Act, the repeal effort is becoming a bigger political problem for Republicans, whose constituents want to know how the changes will affect them.

“Some Republicans have a plan but I don’t think it will be a plan that makes the American public or current insurance carriers very happy, so I am not sure how it will play out,” she says.

Republican 2nd District U.S. Rep. Bruce Poliquin declined to be interviewed for this story, but issued a statement saying he supports the process underway because the program costs have become too high.

He wants a replacement program that includes coverage for pre-existing health conditions and agrees that young adults remain eligible for coverage under their parents’ health plan until age 26. But he also says he wants to eliminate the “job killing taxes,” such as the medical device tax, that are used to help pay for the ACA.

It’s expected there will be several more debates in both the House and Senate before the issue is resolved.

Journalist Mal Leary spearheads Maine Public's news coverage of politics and government and is based at the State House.