Members of the Maine House of Representatives are expected to debate Senate changes to a bill that would overhaul the state’s health insurance market.   

In a nocturnal session yesterday, Senate Republicans wooed the support of three Democrats and the chamber’s lone independent with two amendments clarifying aspects of the bill, LD 1333, which was ultimately approved by a margin of 24-10. 

The House, which engrossed the bill in a 79-68 vote on Tuesday, must now either concur with the Senate amendments or adhere to its own iteration of the bill. 

Debate in the Senate centered on misgivings about the bill’s impact on Maine’s rural and elderly populations. 

Consumer advocacy groups and the AARP contend that older adults will suffer from expanded community rating bands, the allowable premium differentials established by the Bureau of Insurance.  Under LD 1333, insurers could raise the premium charged to an older individual from 50 percent up to 500 percent more than the premium charged to a younger individual.  

Supporters of the bill argue that lower premiums for younger and healthier individuals will entice them back into the market, thereby broadening the pool of insured members to the point where premiums for the elderly begin to fall.  Opponents acknowledge that the younger demographic will benefit, but are skeptical that lower premiums for the older segment will materialize.  

A motion to send the bill back to the Insurance and Financial Services committee was defeated in a 23-11 vote. 

The Senate did vote, however, to adopt an amendment introduced by Bill Diamond (D-Windham) that slightly modified the bill. 

Diamond’s amendment consists of three parts: it preserves provisions that enable carriers to expand age and occupation rating bands, but limits their flexibility to expand rating bands based on geographic location; it allows carriers to provide incentives for patients to use designated providers, but forbids them from compelling patients to use designated providers; and it clarifies that rating bands may expand only to the extent permitted under the federal Affordable Care Act.  

Senators also adopted an amendment proffered by Elizabeth Schneider that caps the assessment on Maine insurance plans to no more than a monthly $6 per member.  The original language of the bill did not specify a limit. 

Amendments proposed by Sens. Joe Brannigan (D-Portland) and Phil Bartlett (D-Gorham) faltered in successive votes.  The amendments would have included Vermont in the list of states permitted to sell health insurance products in Maine beginning in 2014; scotched the provision to repeal Rule 850, an administrative rule that prohibits carriers from denying reimbursement for claims from an out-of-network provider within a certain radius of a patient’s home; and barred the Reinsurance Association from imposing assessments to fund its activities. 

Floor leaders from both parties said they would be caucusing prior to debate on the amended bill scheduled for this afternoon.