An Act To Lower the Cost of Health Insurance
Maine Legislature, Session 123, LD 1047
Committee Amendment CA_A_H666 (House)
Amends: 24-A MRSA §2849-B

COMMITTEE AMENDMENT " ~" to H.P. 765, L.D. 1047, Bill, "An Act To 
Lower the Cost of Health Insurance" 
Amend the bill in Part A in section 6 in paragraph G in the first line (page 1, line 21 
in L.D.) by striking out the following: "2008" and inserting the following: '2009' 
Amend the bill in Part A in section 6 in paragraph G in the 2nd line (page 1, line 22 
in L.D.) by striking out the following: "2008" and inserting the following: '2009' 
Amend the bill in Part A in section 6 in paragraph G in the last line (page 1, line 24 in 
L.D.) by striking out the following: "2008" and inserting the following: '2009' 
Amend the bill in Part A in section 13 in paragraph A in subparagraph (11) in the first 
line (page 3, line 30 in L.D.) by striking out the following: "health insurance risk" and 
inserting the following: 'chronic care' 
Amend the bill in Part A by striking out all of section 14 and inserting the following: 
'Sec. A-14. 24-A MRSA §2849-B, sub-§2, ,A, as amended by PL 2007, c. 199, 
Pt. 0, §4, is further amended to read: 
A. That person was covered under aH ifldividual, !! group or blanket contract or 
policy issued by a nonprofit hospital or medical service organization, insurer, or 
health maintenance organization or was covered under an uninsured employee benefit 
plan that provides payment for health services received by employees and their 
dependents or a governmental program, including, but not limited to, those listed in 
section 2848, subsection I-B, paragraph A, subparagraphs (3) to f-l-()) QD. 
For 
purposes of this section, the individual, group or blanket policy under which the 
person is seeking coverage is the "succeeding policy." The group, or blanket eF 
individlial contract or policy, uninsured employee benefit plan or governmental 
program that previously covered the person is the "prior contract or policy"; and' 
Amend the bill in Part A in section 15 in chapter 54 in the 2nd line (page 4, line 5 in 
L.D.) by striking out the following: "HEALTH INSURANCE RISK" and inserting the 
following: 'CHRONIC CARE' 
COMMITTEE AMENDMENT 
" e\~' 
",. 
COMMITTEE AMENDMENT" A 
.. to H.P. 765, L.D. 1047 
Amend the bill in Part A in section 15 in §390 1 in the first paragraph in the first line 
(page 4, line 7 in L.D.) by striking out the following: 
"Health Insurance Risk" and 
inserting the following: 'Chronic Care' 
Amend the bill in Part A in section 15 in §3902 in subsection 1 in the first line (page 
4, line 12 in L.D.) by striking out the following: "Health Insurance Risk" and inserting 
the following: 'Chronic Care' 
Amend the bill in Part A in section 15 in §3902 in subsection 11 in paragraph B in 
the 2nd line (page 5, line 30 in L.D.) by striking out the following: "risk" and inserting 
the following: 'chronic care' 
Amend the bill in Part A in section 15 in §3903 in the first line (page 6, line 1 in 
L.D.) by striking out the following: 
"Health Insurance Risk" and inserting the 
following: 'Chronic Care' 
Amend the bill in Part A in section 15 in §3903 by striking out all of subsection 
(page 6, lines 2 to 5 in L.D.) and inserting the following: 
'1. 
Chronic care pool established. 
The Comprehensive Chronic Care Pool 
Association is established as a nonprofit legal entity. As a condition of doing business, 
an insurer that has sold medical insurance within the previous 12 months or is actively 
marketing a medical insurance policy in this State must participate in the association. ' 
Amend the bill in Part A in section 15 in §3908 in the first paragraph in the 2nd line 
(page 11, line 29 in L.D.) by striking out the following: 
"2007" and inserting the 
following: '2008' 
Amend the bill in Part A in section 15 in §3908 in the first paragraph in the 3rd line 
(page 11, line 30 in L.D.) by striking out the following: 
"2008" and inserting the 
following: '2009' 
Amend the bill in Part A in section 15 in §3912 in subsection 1 in the 3rd line (page 
14, line 31 in L.D.) by striking out the following: "2008" and inserting the following: 
'2009' 
Amend the bill in Part A in section 15 in §3912 in subsection 1 in paragraph A in the 
2nd line (page 14, line 35 in L.D.) by striking out the following: "2008" and inserting the 
following: '2009' 
Amend the bill in Part A in section 15 in §3912 in subsection 1 in paragraph A in the 
last line (page 14, line 38 in L.D.) by striking out the following: "2008" and inserting the 
following: '2009' 
Amend the bill in Part A in section 15 in §3912 in subsection 3 in the first line (page 
15, line 14 in L.D.) by striking out the following: "2012" and inserting the following: 
'2013' 
Amend the bill in Part A in section 16 in the next to the last line (page 15, line 19 in 
L.D.) by striking out the following: "Health Insurance Risk" and inserting the following: 
'Chronic Care' 
Amend the bill in Part A by striking out all section 17 and inserting the following: 
COMMITTEE AMENDMENT 
\\. ~ ~. 
COMMITTEE AMENDMENT" A 
"to H.P. 765, L.D. 1047 
'Sec. A-17. 
Comprehensive Chronic Care Pool Association subsidy 
program. The board of directors of the Comprehensive Chronic Care Pool Association 
shall develop a plan to subsidize low-income individuals as authorized under the Maine 
Revised Statutes, Title 24-A, section 3905, subsection 2, paragraph P. The board shall 
submit that plan to the joint standing committee of the Legislature having jurisdiction 
over insurance and financial services matters no later than February 1, 2009. The joint 
standing committee may submit legislation to the First Regular Session of the 124th 
Legislature to implement the plan submitted by the association.' 
Amend the bill in Part A in section 18 in the 3rd line (page 15, line 31 in L.D.) by 
striking out the following: "2008" and inserting the following: '2009' 
Amend the bill in Part A in section 18 in the 5th line (page 15, line 33 in L.D.) by 
striking out the following: "2008" and inserting the following: '2009' 
Amend the bill in Part A in section 18 in the last line (page 15, line 35 in L.D.) by 
striking out the following: "2008" and inserting the following: '2009' 
Amend the bill in Part B by striking out all of section 1. 
Amend the bill in Part B in section 13 in §2808-C in subsection 1 in paragraph G in 
the next to the last line (page 19, line 1 in L.D.) by inserting after the following: 
"paragraph A," the following: 'A-I,' 
Amend the bill in Part B in section 13 in §2808-C in subsection 9 in the 3rd line 
(page 22, line 30 in L.D.) by striking out the following: 
"2009" and inserting the 
following: '2010' 
Amend the bill in Part B by striking out all of sections 23 and 24. 
Amend the bill in Part B in section 28 in the first line (page 26, line 39 in L.D.) by 
striking out the following: "2009" and inserting the following: '2010' 
Amend the bill in Part E in section 1 in the 3rd line from the end (page 29, line 26 in 
L.D.) by striking out the following: "2008" and inserting the following: '2009' 
Amend the bill by inserting after Part E the following: 
'PART F 
Sec. F-l. 
Study of reinsurance. 
The Comprehensive Chronic Care Pool 
Association established pursuant to the Maine Revised Statutes, Title 24-A, section 3903 
shall conduct a study of the possibility of offering a reinsurance pool for the small group 
health insurance market in order to spread the cost of high-risk individuals for the small 
group medical insurance market. The study must address the costs, potential funding 
mechanisms and effectiveness of a reinsurance pool. The study must also compare the 
feasibility and costs of a reinsurance pool available to all small groups of 50 or fewer 
members and a reinsurance pool for small groups of 10 or fewer members. 
The 
association may address any other issues regarding a reinsurance pool that it determines 
are relevant in the study. The association shall submit its report to the joint standing 
committee of the Legislature having jurisdiction over health insurance matters by March 
COMMITTEE AMENDMENT 
I"~ ,f, ·iJ· 
COMMITTEE AMENDMENT" ~ "to H.P. 765, L.D. 1047 
1,2009. The joint standing committee of the Legislature having jurisdiction over health 
insurance matters may submit legislation implementing the recommendations in the 
report to the First Regular Session of the 124th Legislature. 
PART G 
Sec. G-l. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
Office of Licensing and Regulatory Services Z036 
Initiative: Deallocates funds and eliminates 2 positions responsible for administering the 
certificate of need provisions. The elimination of the certificate of need provisions will 
1 
also result in a reduction in Other Special Revenue Funds revenue of approximately 
$198,000 per year. 
OTHER SPECIAL REVENUE FUNDS 
2007-08 
2008-09 
POSITIONS - LEGISLATIVE COUNT 
0.000 
(2.000) 
Personal Services 
$0 
($156,909) 
All Other 
$0 
($20,000) 
OTHER SPECIAL REVENUE FUNDS TOTAL 
$0 
($176,909) 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY DHS) 
DEPARTMENT TOTALS 
2007-08 
2008-09 
OTHER SPECIAL REVENUE FUNDS 
$0 
($176,909) 
DEPARTMENT TOTAL - ALL FUNDS 
$0 
($176,909) 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Insurance - Bureau of 0092 
Initiative: Deallocates funds and eliminates one half-time Insurance Actuarial Assistant 
position and related costs effective July 1, 2008, which are no longer necessary as a result 
of repealing the certificate of need provisions. 
OTHER SPECIAL REVENUE FUNDS 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
2007-08 
0.000 
$0 
COMMITTEE AMENDMENT 
2008-09 
(0.500) 
($42,070) 
COMMITTEE AMENDMENT" A 
"to H.P. 765, L.D. 1047 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Insurance - Bureau of 0092 
$0 
($3,500) 
$0 
($45,570) 
Initiative: Allocates funds on a one-time basis for the costs of contracting with another 
entity to prepare a grant application. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
PROFESSIONAL AND FINANCIAL 
REGULATION, DEPARTMENT OF 
DEPARTMENT TOTALS 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
SECTION TOTALS 
OTHER SPECIAL REVENUE FUNDS 
SECTION TOTAL - ALL FUNDS 
2007-08 
$0 
$0 
2007-08 
$0 
$0 
2007-08 
$0 
$0 
2008-09 
$15,000 
$15,000 
2008-09 
($30,570) 
($30,570) 
2008-09 
($207,479) 
($207,479) 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment is the minority report of the committee. The amendment changes 
the name of the Comprehensive Health Insurance Risk Pool Association to the 
Comprehensive Chronic Care Pool Association. The amendment adds a requirement that 
the Comprehensive Chronic Care Pool Association established in the bill conduct a study 
of the possibility of offering a reinsurance pool for the small group health insurance 
market, including a comparison of the feasibility and costs of a reinsurance pool for small 
groups of 50 or fewer members and a reinsurance pool for small groups of 10 or fewer 
members. 
The report must be submitted to the joint standing committee of the 
COMMITTEE AMENDMENT 
... 
~. 
I 
COMMITTEE AMENDMENT" A " 
to H.P. 765, L.D. 1047 
Legislature having jurisdiction over health insurance matters by March I, 2009, and 
legislation to implement the recommendations in the report may be submitted by the joint 
standing committee to the First Regular Session of the I 24th Legislature. 
The amendment also changes dates in the bill to reflect the time line based on 
enactment of the bill during the second regular session. 
This amendment also adds an appropriations and allocations section to the bill. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 01/17/08 ;tJvac 
LD 1047 
LR 677(02) 
An Act To Lower the Cost of Health Insurance 
Fiscal Note for Bill as Amended by Committee Amendment" A " 
Committee: Insurance and Financial Services 
t\ppropriations/ Allocations 
Other Special Revenue Funds 
Revenue 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
Future biennium cost increase - General Fund 
2007-08 
2008-09 
$0 
($207,479) 
$0 
($198,000) 
Projections 
2009-10 
($229,500) 
($198,000) 
Projections 
2010-11 
($236,790) 
($198,000) 
The bill's elimination of the certificate of need program could result in increased costs to the MaineCare program as a 
result of increased provider service capacity. 
Includes a deallocation of funds and eliminates two positions in the Office of Licensing and Regulatory Services in the 
Department of Health and Human Services responsible for administering the certificate of need (CON) provisions. 
The elimination of the certificate of need provisions will also result in a reduction in Other Special Revenue Funds 
revenue of approximately $198,000 per year. 
Also includes a deallocation of funds and eliminates one half-time Insurance Actuarial Assistant position and related 
costs in the Bureau of Insurance no longer necessary as a result of repealing the certificate of need provisions. 
Provides an allocation of funds to the Bureau of Insurance on a one-time basis for the costs of contracting with another 
entity to prepare a grant application. 
LR0677(02) - Fiscal Note - Page 1 of 1