By U.S. Sen. Angus King
(I-Maine)
There is a part of the Affordable Care Act that gets very little mention and generates very little controversy – and it’s a provision that enabled local organizations within states to form non-profit, cooperative entities that provide insurance to their citizens. And one of the most successful of those organizations is Maine Community Health Options.
The story of Maine Community Health Options (MCHO) is a story of creative and dedicated Maine professionals who were willing to take a risk and try to implement a new idea. The Affordable Care Act provided the chance 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 MCHO founders, saw an opportunity in the ACA to develop this idea. They knew what was needed to address the challenges of health care coverage for Maine citizens, and working with a group of people in Maine who shared their concerns about health care, they built MCHO on this vision of meeting Maine 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 was for 15,000 signups. By the time the dust settled at the deadline last spring, they had 40,000 signups – 83 percent of the marketplace signups in Maine. And this year, they have over 60,000 signups.
The explosion of signups from zero to 60,000 is a jobs story as well. MCHO 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. And even their chosen location is a good-news story. They’re in an old Lewiston textile mill, which is now humming again with activity, new jobs, and people supporting their families.
It is also a story of local control. MCHO held elections for the board – a board that has to be made up of 51 percent of actual MCHO members. In other words, the people who use the products, who buy the health insurance, are actually making decisions about how those products should be designed – and they’re responsible to the folks who elect them.
The structure of the organization is only part of the story. They are also focused on the business of health – individual health, community health, and prevention. 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. And preventive measures like these are how we’re going to save money in the healthcare system.
And what has MCHO done for its members’ rates? The group has reduced its already competitive rates by 1 percent this year, and that competitive pressure, some believe, has also brought pressure to reduce rates for other providers and other carriers in Maine.
This is a great story. This is people that saw an opportunity created by the Affordable Care Act to start a new kind of health insurance company – one that’s owned and run by its members, delivering quality health care and insurance coverage, helping to control costs, and perhaps most importantly, taking an active role in assisting its members in improving their own health.
Better health coverage, better health, at a lower cost – what’s not to like about that formula?
