Maine

Last week I noted that six states have launched window shopping for the 2026 ACA Open Enrollment Period (OEP), allowing residents of the following states to plug their household information into their states ACA exchange website to see just how much their net health insurance premiums are going to increase starting January 1st, 2026:

Today another seven states joined them by activating 2026 window shopping as well:

Originally posted 6/11/25

via the Maine Bureau of Insurance:

Each year insurers that sell Individual and Small Group plans in Maine's pooled risk market must submit their proposed forms and rates to the Bureau of Insurance, using the System for Electronic Rate and Form Filing (SERFF). Details of the filings submitted to the state since June 10, 2010 can be viewed in the system.

Anthem Health Plans of Maine:

The proposed rates have been developed from 2024 Individual and Small Group ACA combined experience, and the proposed average annual rate change at the Merged Market level is 18.0%.

The proposed annual rate changes by product for Individual range from 17.9% to 20.6%, with rate changes by plan from 10.1% to 30.0%. These ranges are based on the renewing plans, and are consistent with what is reported in the Unified Rate Review Template. Exhibit A shows the rate change for each plan.

Factors that affect the rate changes for all plans include:

Originally posted 1/09/25

Maine has around 64,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~4,500 unsubsidized off-exchange enrollees.

Combined, that's around 70,000 people, although it could be somewhat lower due to net enrollment attrition since January.

Originally posted 3/08/25

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

The following letter was just sent to both Republican House Speaker Mike Johnson and Democratic House Minority Leader Hakeem Jeffries:

Dear Speaker Johnson and Leader Jeffries:

For over a decade, State-Based Marketplaces have provided private health coverage to tens of millions of Americans, ensuring their health, well-being, and economic security. The Americans who depend on the Marketplaces include working parents, small business owners, farmers, gig workers, early retirees, and lower and middle-class individuals of all ages, political views, and backgrounds who drive our local economies and make both our rural and urban communities thrive.

The legislation under consideration in the House will severely impact the ability of these millions of Americans to continue to access this coverage and the health and financial security they depend on today. This will make for a sicker, less financially secure American public and strain hospitals and health care providers by increasing uncompensated care.

via the Maine Dept. of Health & Human Services:

With potential Federal cuts to Medicaid on the horizon, renewing enhanced premium tax credits to ensure affordable insurance through the marketplace takes on greater significance

AUGUSTA— The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) today announced its support for renewing the enhanced premium tax credits for consumers of the health insurance marketplace. 

The enhanced premium tax credits, which were first implemented in 2021 through the American Rescue Act and extended in the Inflation Reduction Act are set to expire at the end of this year unless Congress acts. Allowing these federal tax credits to expire will result in higher health insurance premiums for Maine consumers, potentially putting health coverage out of reach for thousands of Mainers. Overall, the enhanced tax credits are saving Mainers a conservative estimate of nearly $90 million in health care premium savings this year.

via CoverME.gov:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2025. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2025 is December 15, 2024. Consumers who select a plan between December 16, 2024 and January 15, 2025 will have coverage beginning February 1, 2025.

 CoverME.gov Activity Through January 16, 2025

via CoverME.gov:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2025. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2025 is December 15, 2024. Consumers who select a plan between December 16, 2024 and January 15, 2025 will have coverage beginning February 1, 2025. 

via CoverME.gov:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2025. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2025 is December 15, 2024. Consumers who select a plan between December 16, 2024 and January 15, 2025 will have coverage beginning February 1, 2025. 

via CoverME.gov:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2025. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2025 is December 15, 2024. Consumers who select a plan between December 16, 2024 and January 15, 2025 will have coverage beginning February 1, 2025. 

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