- Associated Press - Sunday, July 30, 2017

AUGUSTA, Maine (AP) - Maine residents are lambasting health care insurers for proposing double-digit premium hikes they say would hurt the state’s middle and lower classes.

Harvard Pilgrim and Anthem Inc. have both said they may leave the Affordable Care Act marketplace in the nation’s oldest state next year, citing rising health care costs driven by pharmaceutical drug prices and uncertainty over the health care law’s future.

Harvard Pilgrim, Anthem, and a third provider, Maine Community Health Options, are all asking customers to pay more.

Dozens of public comments submitted to the state raised objections about the proposed premium increases. Some policyholders saying they don’t qualify for health care subsidies under proposals being debated in Congress.

Roughly 80,000 Maine residents are enrolled in ACA plans, and about 60,000 individuals receive tax credits to lower premium costs while nearly 37,000 receive subsidies.

Michael Archibald, a Portland resident who owns a Boston hair salon, said it’s tough for people who are self-employed to afford rising premiums for plans. This year’s proposed premium increases follow double-digit hikes approved last year.

“You basically have to be in the poor house to get any subsidies,” he said.

Archibald, an Anthem policyholder, said his premium for a plan covering him and his husband has risen from $750 in 2016 to $920 this year. It could increase to $1,200 next year.

“You’re going to throw all these costs on people who are middle class or lower middle class, and you’re not addressing the real problem with the actual health care costs,” he said.

Mike Smith, a physical therapist who owns a business in Gorham, said he now pays $1,400 a month for himself, his wife and 10-year-old son, and says he sees insurers’ blaming rate increases on uncertainty as a “lame excuse.”

“It’s really the consumer who takes the hit, not so much the insurance companies,” he said.

Maine Community Health Options CEO Kevin Lewis attributed the proposed rate increase to “the weak mandate and the market uncertainty” along with signs that there will be fewer ACA enrollees leading to a sicker pool in Maine.

“We only have one chance for states to set rates for the upcoming year and we know painfully well that to get those wrong, the carriers would be in a world of hurt for quite some time,” Lewis said.

Anthem’s spokesman defended the rate increases as reflecting “the increases in the cost of delivering medical services coupled with pharmacy expenses and the overall increased use of health care services by Maine members in ACA plans.”

Harvard Pilgrim didn’t respond to a request for comment.

The future of the Affordable Care Act’s individual mandate and subsidies remains unclear as repeal efforts continue in Washington.

Maine regulators have asked for two sets of premium increases from insurers - one if Congress funds the $7 billion pool of cost-sharing subsidies paid to insurers and another if Congress does not. President Donald Trump has indicated a desire to halt the payments, which are the subject of a House Republican lawsuit, but so far has allowed them to continue on a month-to-month basis.

Maine Republican U.S. Sen. Susan Collins said on CNN’s “State of the Union” on Sunday that the “threat to cut off” such subsidies has contributed to market instability.

“We’re talking about low-income Americans who would be devastated if those payments were cut off,” she said.

Steve Butterfield, of advocacy group Consumers for Affordable Health Care, called this an “unusual moment and everyone recognizes that.”

“But just because there is political uncertainty doesn’t mean the basic underlying assumptions can be waved away to allow big rate increases,” he said.

State regulators could make a final decision on premium hikes for individual Affordable Care Act plans as late as Aug. 16.

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