ME | Maine took historic action today that will create more stable pricing in both its Individual and Small Group health insurance markets, starting in 2023.
As outlined in Governor Mills’ 2020 Made for Maine Health Coverage Act, which passed in the Legislature on a bipartisan basis, Maine Insurance Superintendent Eric Cioppa today issued an Order that will merge Maine’s Individual and Small Group Health Insurance markets.
The merger, which will pool the risks of the two markets and roll the Small Group coverage into the Maine Guaranteed Access Reinsurance Association (MGARA), is projected to reverse the trend of steady premium increases and declining enrollments in Maine’s Small Group Market, while supporting continued stable pricing in the Individual Market.
Superintendent Cioppa has applied to the federal Centers for Medicare and Medicaid Services (CMS) to amend Maine’s 1332 State Innovation Waiver to enable MGARA to support the small group market by sharing the cost of high-impact claims. If approved, the amended waiver will be the first in the nation under the Affordable Care Act’s 1332 waiver program to provide assistance to small employers as well as individuals.