Jackson, Legislative Democrats’ Patients First bills clear committee

Posted: March 13, 2020 | Health Coverage, Insurance and Financial Services, Senator Claxton, Senator Jackson

AUGUSTA — The Health Coverage, Insurance and Financial Services Committee has approved all four bills included in Legislative Democrats’ Patients First health care package as of Thursday. The Patients First package is a suite of health care reform bills – sponsored by Senate President Troy Jackson, D-Allagash, Speaker Sara Gideon, D-Freeport, and Sen. Ned Claxton, D-Auburn – that advocates for Maine health consumers, protects against abusive and surprise billing practices, and increases access to and limits the cost of insulin.

“When Mainers are saying that the worst part of illness or disease is having to deal with a complicated health care system, we know that we’ve got a problem. For too many Mainers the cost of care, insurance company bureaucracy and surprise fees stand in the way of their health and well-being,” said President Jackson. “Our Patients First health care package came from listening to Mainers from all across the state, who shared their stories and demanded change. Yesterday’s committee vote was a good first step, but we must keep up the momentum and get these bills across the finish line. Mainers are counting on us.”

An amended version of President Jackson’s bill  – LD 2110, “An Act to Lower Health Care Costs” – creates a nonpartisan Office of Affordable Health Care to take control of growing costs in a complicated health care system. The office will examine Maine’s health care system and make critical recommendations to the Legislature on an annual basis. This office will also look at cost-related trends, quality trends, health care spending, consumer experience and satisfaction. 

Nine other states, including Massachusetts and Vermont, have similar health care commissions that have delivered significant savings. In Massachusetts, the Health Policy Commission saved patients and businesses $7.2 billion. In Vermont, the Green Mountain Care Board saved rural hospitals $7.3 million.

“When I heard about people rationing their insulin or delaying filling their prescriptions, I knew we needed to take immediate action to lower the cost of this life-saving medication. Putting together our Patients First health care package was about fixing some of the most common and troublesome health care problems facing Mainers today,” said Speaker Gideon. “In the absence of continued inaction on the federal level, whether it is on addressing the cost of prescription drugs or outrageous surprise bills, we are addressing and fixing our broken health care system in every way we can here in Maine. I’m proud of the support we received in committee today and we’re going to keep up the momentum.”

Two bills in the Patients First health care package are from Speaker Gideon. The first bill would cap the out-of-pocket cost of insulin at $35 for a 30-day supply for patients in the individual and small group markets, and allows pharmacies to provide patients insulin based on an old prescription in emergencies – this is also known as “Kevin’s Law.” If passed, the bill would take effect for plans issued or renewed beginning January 1, 2021. The second bill protects patients from high-cost bills from out-of-network providers when they never had an opportunity to choose a cheaper option. A recent study shows that one in five inpatient emergency department cases may lead to surprise bills.

The final bill from Sen. Claxton – LD 2111, “An Act to Establish Patient Protections in Billing for Health Care” – protects patients from abusive billing practices and unnecessary patient fees. It requires providers to alert patients when they’ve been referred out-of-network, gives Medicare patients more information about the potential cost of care, and protects patients from unnecessary, unexplained bills when they make appointments with new doctors or move between doctors. Almost 70 percent of Americans are worried about unexpected medical bills. 

“I believe patients deserve basic protections from abusive billing practices. My bill is about putting patients first; making sure they are treated fairly and can make informed health care decisions,” said Sen. Claxton. “I’m grateful to the committee for their thoughtful work on this bill and look forward to it becoming law.”

All four bills will now go before the full Legislature for additional votes.