The U.S. House of Representatives recently passed a health care reform bill, and we should thank 2nd District U.S. Rep. Bruce Poliquin for voting in favor of it, not demonize him.

Might I remind everyone that the Affordable Care Act is not doing so well? Does anyone recall the average 25 percent rate increases for individual policies just a few short months ago and the 100 percent-plus increases reported in other states, or the multiple headlines announcing insurers abandoning ACA marketplaces?

I think we can agree that ensuring access to health care is important, but you can’t achieve that goal if you don’t create stable insurance markets. The Republicans like Poliquin recognize that, and, looking at the bill passed Thursday, they also care about people with pre-existing health conditions.

The American Health Care Act protects people with pre-existing conditions with an invisible risk-sharing program modeled after Maine’s, which lowered rates in Maine’s individual market before Obamacare took effect. Milliman, a well-respected actuarial firm, analyzed the effects of a similar program extrapolated nationally and showed how rates would be lowered for all age groups.

So why are alarm bells sounding? The attention seems to be on an amendment to the bill that enables states to seek waivers to gain additional flexibility in their insurance markets.

Did you know that the waivers are available only if states think they can achieve goals like covering more individuals, better protecting individuals with pre-existing conditions or lowering average premiums? Sound evil to you?


The alarmists are screaming that states could escape having to cover essential health benefits — how awful! Did you know that essential health benefits in Maine track small-group plans sold prior to the Affordable Care Act that cover services already required under Maine law? Did you know the waiver simply says that a state could use their own essential health benefit list if they chose — again, if they felt it could achieve a stated goal, like the examples above?

Even worse, waivers could allow insurers to charge someone more based on their health status! Did you know that, under Maine law, an insurer cannot rate a policy based on health status? Does anyone think the Maine Legislature plans on changing that any time soon?

The waiver also requires utilizing the federal invisible risk-sharing program or a similar state program. Did you know the federal and Maine risk-sharing programs are specifically designed to lower premiums while allowing individuals with pre-existing conditions to purchase the same policies at the same rates as if they were healthy?

But wait — the American Health Care Act allows surcharging premiums for people with a gap in coverage! Democrats and Republicans alike recognize that you can’t have a system where people wait until they are sick to buy coverage. If you try to buy coverage under the ACA after going too long without, you are told you can’t enroll at all until the next annual open enrollment period. Do you want to pay higher premiums so someone else can sit on the sidelines and buy only when they need the coverage?

The waiver in the American Health Care Act is only a tool for additional flexibility if, at the state level, we feel we could use flexibility to better care for our citizens. Flexibility is just that, and the opponents jumping immediately to the risk of that flexibility being used to harm versus help is a mischaracterization of the bill and the intent of the lawmakers who passed it.

I don’t think the AHCA is a perfect bill. I do think it provides a solid framework for the Senate to work with. It improved as it worked through the House and will improve further in the Senate. I don’t expect the final product will be perfect, but neither was the ACA, and already the bill is addressing some of the fatal flaws that have plagued the ACA.

Back to Rep. Poliquin: I’d like to say, “Thank you for staying principled and keeping the focus on getting the policy right, not political expediency. Please keep that focus as the bill progresses and ultimately comes back to the House before final passage.”

Rep. Poliquin is serving Maine well on this issue, and I thank him for that. You should, too.

Joel Allumbaugh is a Maine insurance consultant, president of the Allumbaugh Agency in Augusta and senior fellow with the Naples, Florida-based Foundation for Government Accountability.

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