BY JOE LAWLOR

Portland Press Herald

An Aroostook County resident who buys the exact same health care plan on the new insurance exchange as a Portland resident could pay $1,000 or more per year in premiums for the same coverage, according to information released by the Maine Bureau of Insurance on Wednesday.

The Bureau on Wednesday released the rates insurance companies would charge on the new exchange, set to go into effect Jan. 1 as part of the Affordable Care Act. Residents, mostly the self-employed or the otherwise uninsured, can begin purchasing insurance on the exchange on Oct. 1.

But how much a consumer pays will not only depend on how comprehensive coverage will be, but will also be based on age, tobacco use and where the person lives.

Under one example, a plan valued at $300 per month would cost $354 monthly in Aroostook County and $267 in Portland for a consumer purchasing the same plan from Maine Community Health Options, one of two insurance providers on the new exchange. The other insurance provider, Anthem Blue Cross Blue Shield, also charges different rates based on geography.

Recent laws approved by the state legislature have made it easier for insurance companies to vary rates based on geography, said Joseph Ditre, executive director of health care advocacy group Consumers for Affordable Health Care.

The insurance industry lobbied for the changes, and starting in 2011 were allowed to more easily charge different rates on the individual market based by county, Ditre said. Prior to 2011, while insurance companies could technically charge different rates by region, in practice it wasn’t done, Ditre said, because geography was lumped together with age. In practice, Ditre said the insurance companies typically charged different rates based on age but not on geography, until 2011.

In 2013, a compromise in the state legislature created four broad regions where insurance companies could charge varying rates, instead of a separate rate for each county. The regions are the same for plans to be offered on the exchange and currently for off-exchange plans on the individual market.

But the compromise still leaves rural Mainers paying more for the same health care coverage than urban residents in southern Maine.

Ditre — who unsuccessfully lobbied the legislature to not allow the rates to vary by region — said residents shouldn’t be penalized based on where they live.

“Maine is a small enough state that we don’t need to do this,” Ditre said. “You ask yourself ‘Why?’ and the only answer you get is ‘because they can.'”

But Kevin Lewis, chief executive officer of Maine Community Health Options, said that one reason the rates vary is because it costs more to deliver health care services in rural areas compared to more urban regions.

“Geography is taking on a bigger role than before. But there are different underlying costs from area to area,” Lewis said.

For instance, Lewis said it takes longer for patients to get to a hospital in rural areas, which not only jeopardizes the patient but can often make the care more costly.

But Lewis said MCHO, which is a new co-op offering insurance on the exchange, is working to reduce some of the reasons why the costs are different by region. For instance, MCHO will cover remote monitoring for patients with congestive heart failure and chronic obstructive pulmonary disease, which should help patients recognize problems and get to the hospital before symptoms progress too far. The remote monitoring will help residents in outlying areas more than urban residents.

Meanwhile, whether the rates released on Wednesday by the Bureau of Insurance will overall cost consumers more or less than now remains to be seen, as many details have not yet been released. The plans offered on the exchange are much different than current plans on the individual market, Ditre said.

Ditre said he hopes the Bureau of Insurance will soon put together an easily-understandable rate chart so that people can better comprehend what they’re purchasing.

The bureau will be holding a series of informational meetings in August to help people figure out how to purchase insurance on the exchange.

Those meetings will begin at 6 p.m. at the following locations and dates:

Aug. 15, University of Southern Maine in Portland

Aug. 16, Husson University, Bangor

Aug. 29, Central Maine Community College, Auburn

Aug. 30, University of Maine, Presque Isle

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