Call Your Legislators and Urge Them to Support the Bipartisan “Ought Not to Pass” Report on LD 1539, An Act Provide Access to Fertility Care

New increased costs could range from an additional $5 to $6 per person/employee per month

A majority of the Joint Standing Committee on Health Coverage, Insurance and Financial Services (HCIFS) has approved a sweeping health insurance mandate contained in LD 1539, An Act Provide Access to Fertility Care, which will significantly add to the cost of insurance for individuals, small businesses, and large employers – and for employees who receive coverage from their workplace.

• The Maine Bureau of Insurance (BOI) is required to conduct a study of the impact on utilization and cost to determine the overall impact of the proposal on health insurance premiums – unless the legislature bypasses the study requirement.
  

 

• In their report to the HCIFS committee, the Bureau estimates that costs will increase between $5.03 to $6.32 per insured employee per month, without cost sharing.
  

 

• This mandate would apply to all individual, small group, and large group plans sold in Maine.
  

 

• Part of the steep costs associated with LD 1539 is the fact that insurers are prohibited from implementing any type of limitations on the coverage – for example, limiting costs per procedure, the number of times individuals can seek treatment per year, the age of the individual seeking the treatment, and others.
  

 

• Without guardrails, passage of LD 1539 would result in one of the most expensive mandates applied to coverage in Maine in nearly two decades.

 

• We recognize and are deeply sympathetic to the plight of those individuals who wish to have children but cannot. We also acknowledge the clear benefit such a mandate would bring to these folks.

 

• At the same time, we are deeply concerned it would raise the rates of others by socializing the cost across all insureds, whether they access this mandate or not.

 

• Passage of LD 1539 will likely reduce a portion of any savings associated with the merger of the individual and small group markets, which was recently announced by Governor Janet Mills and the BOI and touted as bringing real savings, particularly to small businesses.

 

• At the request of the Mills Administration, the BOI has been working on the merger of the markets for more than a year. According to the bureau, the savings from this merger could result in 6% decrease in the small group market in 2023, falling to 4% in 2024. LD 1539 would diminish those savings with premium increases potentially between 0.90% and 1.13%.

 

• Passage of 1539 will further increase premiums in the individual market, over the already expected increase resulting from the merged market of 6% in 2023, and 8% in 2024. In plain English – people and employers will pay more for health insurance.

 

• Passage of LD 1539 would also reduce the impact of the recently announced Small Business Rate Relief Program, implemented by Governor Mills and the BOI, which is designed to provide up to $40 million in direct premium reductions to both employees and employers. While this is a temporary relief program, LD 1539 creates a permanent increase!

 

• Again, passage of LD 1539 would take away a portion of that direct relief and require every individual and employee to pay for the mandate – even if they never have or intend to use it.

 

• The Maine State Chamber has said that mandated benefits, no matter how well intentioned, serve no purpose if they push health insurance premiums beyond the reach of either the employer or the employee.

 

• The challenge for employers to maintain their health insurance benefits in the coming months and year will depend on many things, and the cost of that insurance is chief among them.

 

• Passage of LD 1539 would impose higher costs on everyone. While we recognize those few could benefit greatly from LD 1539’s enactment, it also may result in the total loss of health insurance coverage for others.

 
Please urge your legislator to support the minority ought not to pass report on LD 1539. For additional information or questions, please contact Peter Gore, executive vice president, by calling (207) 623-4568, ext. 107, or by emailing [email protected].