State insurance exchanges - Maine

Summary of differences between federal and state regulations

The U.S. Department of Health and Human Services (HHS) must make a determination on or before January 1, 2013, that a state will in fact have an exchange in operation by 2014 and that the exchange meets the requirements of the Affordable Care Act (ACA) and HHS guidance. In a letter dated November 15, 2012, Secretary Sebelius indicated that a state may submit both a letter of intent and an application to operate its own exchange by December 14, 2012. If a state elects not to operate an exchange, or if the HHS determines that the state will not be able to have an exchange operational by 2014 that meets the law’s requirements, the ACA gives the HHS the authority to establish and operate such exchange within the state.

The Federal government awarded Maine two grants to build its Affordable Insurance Exchange:

1. The State Planning Grant, awarded September 30, 2010, in the amount of $1,000,000;
2. The Early Innovator Grant, received by the multi-state consortia including Maine, Connecticut, Massachusetts, Rhode Island and Vermont, in the amount of $35,591,333; and
3. The Level One Establishment Grant or $5,877,676, received November 29, 2011.

In April 2012, Maine Gov. Paul LePage informed HHS that Maine had discontinued exchange planning and would not be implementing a state-based insurance exchange and the state would not be utilizing the grant money.

In April 2012, Gov. LePage also signed legislation to create a Navigator program for a state insurance exchange.

In July 2013, the Governor signed legislation clarifying Navigator provisions (S.P. 376, L.D. 1094, CH. 388).

State

Contacts

DHA

Regulations

H.P. 1098 – L.D. 1497 - An Act Relating to Navigators under Health Benefit Exchanges

S.P. 376 - L.D. 1094 - An Act to Fully Implement Health Insurance Exchanges and to Make Maine Law Consistent with Federal Law

Federal

Contacts

Center for Consumer Information and Insurance Oversight (CCIIO)

U.S. Department of Health and Human Services (HHS)

Regulations

45 CFR Parts 155, 156, and 157