February 10, 2015
Mr. President, I rise to speak about a little-discussed aspect of the Affordable Care Act. Before touching on the main subject, I should point out that I think as of tonight there will be more than 11 million Americans who will have already signed up for health care coverage under the Affordable Care Act so far this year. Of course, the deadline is coming up next week, and this weekend there could be a very large influx of newly insured Americans, which I think is an occurrence we should all feel very proud of and should celebrate.
I wish to speak about a part of the Affordable Care Act that gets very little mention, very little discussion, and very little controversy. It is a provision that enables local organizations within a State to form cooperative insurance entities, to form nonprofits, to provide insurance to their citizens. Today I wish to speak about one of those--and one of the most successful in the country--the Maine Community Health Options program.
It is a story of an opportunity. It is a story of a vision. It is a story of an idea. It is a story of risk taking. It is a story of creative and dedicated Maine professionals who were willing to take a risk and try to implement a new idea. It is one of the health insurance co-ops, as I mentioned, that was established by the Affordable Care Act. The Affordable Care Act provided the opportunity to develop something new and different in health insurance--a company where purchasers of health insurance also become members and then elect other members to serve on the board of directors of their insurance company.
Kevin Lewis and Robert Hillman, two of the founders, saw an opportunity in the ACA to develop this idea they knew was needed to address the challenges of health care coverage for Maine citizens. Working with a group of people in Maine who shared their concerns about health care, they built Maine Community Health Options based on this vision of meeting Maine's people's health insurance needs in a direct and hands-on way.
Would it work? Nobody knew. When the enrollment opened last year, their goal, their hope, their vision was for 15,000 signups. By the time the dust settled at the deadline last spring, they had 40,000 signups. Eighty-three percent of the marketplace signups in Maine had signed up with this fledgling company. This year, I am told, as of today they have over 60,000 signups.
I did a tour of their offices recently in Lewiston, ME, and we talked about this phenomenon of all the signups that came unexpectedly. It reminded me of a TV commercial we all saw a few years ago where these young people start an Internet startup. They see the sales orders coming in, and they are happy. Then they start to come in even faster, and they get even more excited. Then they start to come in even faster, and they look at each other and say, what do we do now? These people in Maine experienced exactly that. Great, it is working. A few more. Wow, that is great. Then it went crazy. They all shook their heads. When we talked about this in Lewiston a few weeks ago, they said that is exactly the way it felt.
This sounds simple and straightforward, and it wasn't. When those 40,000 folks were signing up and the systems were challenged, Maine Community Health Options faced those issues head-on. They figured out where the problems were, addressed them, and communicated to members quickly and directly. That is really the Maine way.
The explosion of growth of this little company from zero to 60,000 is a jobs story as well. Maine Community Health Options now employs over 130 people and has even contracted with a local call center in Maine to provide additional customer support during this enrollment period. Even their chosen location is a good-news story. It is a great news story for New England and for Maine because they are in an old textile mill. The textile industry flourished in New England up through the 1950s but then left these beautiful old mills in Lewiston, ME. One of these mills--first one floor and now two floors--is being repurposed for this 21st century project of bringing health insurance to the people of Maine. It is humming with activity, new jobs, and people supporting their families.
It is also a local control story. Maine Community Health Options recently held elections for the board--a board that has to be made up of 51 percent of their individuals who are members who are elected by other members. In other words, the people who use the products and who buy the health insurance are actually making decisions about how those products should be designed. They are responsible to the folks who elect them--like us.
The structure of the organization is only part of the story. I think this is very important. They are also focused on the business of health--individual health and community health. They are focused on prevention.
The cheapest medical intervention of all of this is the one that never occurs, because people have preventive care that keeps them from more serious chronic care. They have a chronic illness support program and a tobacco cessation program which are both designed to make it easier and cheaper for members to manage chronic care or stop smoking. That is how we are going to save money in the health care system. They have a behavioral health partnership creating a nearly seamless transition for members in need of short-term mental health services, with no copay for the first three visits. They are doing community outreach. They recognize many people who have never had health insurance coverage before don't fully understand how to use it. Their community outreach effort includes informational presentations on health care for members and nonmembers alike.
Another part of the good-news story is Maine Community Health Options has just expanded its coverage into New Hampshire and is providing a new health care option for the people of New Hampshire. Whereas last year, as I understand it, New Hampshire only had one option on their exchange, now I think they have at least two, and perhaps three or four, one of which I commend to the Presiding Officer is based in Lewiston, ME.
Finally--and I think this is very important--what has this done for rates? I think we have lost sight of this in the last couple of years. For many years, one of the problems in health care in this country was the exaggerated inflation of health care costs--5, 6, 7, 8 percent a year was not unusual in the late 1990s and the early first decade of this century. That was the typical, somewhat expected inflation in the rates of health care costs--in the cost of health care and, therefore, in insurance rates.
Maine Community Health Options not only has reduced its already competitive rates, reduced its rates by 1 percent this year, but that competitive pressure, we believe, has also brought pressure to reduce rates for other providers and other carriers in Maine.
This is a great news story. This is people who saw an opportunity created by the Affordable Care Act to create a new kind of health insurance company that is owned and run by its members, that is delivering health care, quality health care insurance coverage, to the people of Maine and now the people of New Hampshire, that is helping to control costs, and I think most importantly is taking an active role in assisting its members in improving their own health. Of course, this is about cost. Of course, it is about access. Of course, it is about all the mechanics of health insurance. But in the end, if the result is healthier people, people who need the intervention of the healthcare system less frequently, that is a huge win for those individuals, for our State, for our region, and for our country.
I come to the floor today just to share some good news about an aspect of the Affordable Care Act that is absolutely working, and it is making a huge difference in the lives of thousands, tens of thousands, of Maine people. Better health coverage, better health at a lower cost--what is not to like about that formula?
I am very proud of what these entrepreneurial individuals in Maine have undertaken and the success they have enjoyed so far. I look forward to working with them as they continue the project that has meant so much to my people.
