Maine is one of just two states in the nation where the number of people without health insurance increased in 2013. U.S. Census Bureau data released today indicates that, in one year, the percentage the state's uninsured grew from 10.2 percent to 11.2 percent - an addition of 12,000 people. The figures provide a backdrop as the next enrollment period approaches for the Affordable Care Act's insurance marketplace.
First, let's start with the numbers that consumer health advocates - like Jake Grindle of Western Maine Community Action - are excited about: last year's Marketplace enrollment. "Maine did really well during the last enrollment period," Grindle says.
Grindle says it was projected that 23,000 people would sign up for insurance. "And we ended up getting a little bit better than 44,000, so we almost doubled the projection."
Despite those high enrollment numbers for the Marketplace, Maine's overall number of uninsured is troubling, says Garrett Martin, the executive director of the progressive Maine Center for Economic Policy.
"We are one of two states in the country that actually saw an increase in the percentage of people who didn't have insurance," he says.
Martin is citing U.S. Census Bureau figures for 2013 released Tuesday. The Bureau reports that the number of uninsured in Maine grew by 12,000 people from 2012 to 2013. And though the report's margin of error is 10,000 people, and doesn't account for 2014 enrollment figures, Martin says the preliminary data he's seen doesn't look any better. So why the growth in Maine's uninsured when Marketplace enrollment was such a success?
"When you look at Maine and you see we're so out of step with the rest of the country," Martin says, "I think one can't help but look at the policy decisions made in recent years that potentially might have increased the number of people without health insurance."
Martin is referring to eligibility restrictions to Maine's Medicaid program, known as MaineCare, that Gov. Paul LePage and the Legislature implemented in 2012. Another factor, says Martin, is Maine's resistance to accepting federal funds to expand Medicaid under the Affordable Care Act. He says it would provide insurance to 70,000 Mainers - and an overall boost to the economy.
"We projected, based on our analysis, that Maine is losing roughly $1 million a day by not accepting federal funds," he says. "Well, we've crossed the 250-day mark, so we've lost over $250 million."
In a written statement, LePage's press secretary, Adrienne Bennett, says past Medicaid expansions had little impact on the number of uninsured, and that the eligibility restrictions from 2012 brought Maine in line with national averages for Medicaid coverage. Bennett says, at this point, Maine is still well below the national rate of uninsured, which is 14.5 percent.
With the next enrollment for the federal Marketplace opening from November to February, health policy advocates say they have a lot of work to do in half the amount of time they had last year. Ron Pollack, the executive director of the national consumer health care organization, Families USA, says the biggest challenge to getting people to enroll is the fact that less than two out of five people know there are subsidies available to purchase insurance.
"So we're talking about almost two-thirds of the people who are uninsured are unaware they can get help," Pollack says.
But Deb Shields, an application counselor from Eastport Health Center, says she's seeing a shift in attitude toward the Marketplace compared to last year. "We got a lot of mixed reaction," she says. "There were people who didn't like this plan at all."
Shields says as people have seen neighbors, family or friends enroll, they've realized they can afford insurance coverage. "I'm in Washington County, and I talk to people all the time who have never been able to afford insurance at any level, and can now find insurance coverage that's extraordinary," she says.
Maine has expanded the number of application counselors and navigators throughout the state. Shields says she's hoping word-of-mouth stories will translate into more people walking through the door, looking to enroll for insurance.