An Act To Protect Maine Consumers in the Individual Health Insurance Market and Support Maine's Economy
Maine Legislature, Session 127, LD 1344
Committee: Insurance and Financial Services
Sponsors: SANBORN, GRATWICK, BECK, COOPER, FOLEY, POULIOT, VACHON, KATZ, VOLK

Legislative Document 
No. 1344 
H.P. 913 
House of Representatives, April 16, 2015 
An Act To Protect Maine Consumers in the Individual Health 
Insurance Market and Support Maine's Economy 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
ROBERT B. HUNT 
Clerk 
Presented by Representative SANBORN of Gorham. 
Cosponsored by Senator GRATWICK of Penobscot and 
Representatives: BECK of Waterville, COOPER of Yarmouth, FOLEY of Wells, POULIOT of 
Augusta, VACHON of Scarborough, Senators: KATZ of Kennebec, VOLK of Cumberland. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  24-A MRSA c. 93 is enacted to read: 
CHAPTER 93 
MAINE HEALTH BENEFIT EXCHANGE ACT 
§7201.  Short title 
This chapter may be known and cited as "the Maine Health Benefit Exchange Act." 
§7202.  Maine Health Benefit Exchange established 
1.  Exchange established.  The Maine Health Benefit Exchange, referred to in this 
chapter as "the exchange," is established as the state-based exchange, including the 
federally operated SHOP exchange, pursuant to Section 1311(b)(1) of the federal 
Affordable Care Act.  The exchange's technical functions listed in Section 1311(d)(4) of 
the federal Affordable Care Act, including operation of the publicly accessible website, 
telephone hotline, standardized format for presenting plan information, cost calculator, 
exemption certification process and employer communication process, are those operated 
by the Federal Government under Section 1321 of the federal Affordable Care Act.  
Health insurance carriers offering qualified health plans on the exchange are subject to 
such assessments or user fees as the Federal Government may impose in order to ensure 
that operation of these technical components of the exchange are self-sustaining under 
Section 1311(d)(5) of the federal Affordable Care Act. 
2.  Cooperation with Federal Government.  A state agency or department may 
interact with and cooperate with the Federal Government with respect to operation of the 
exchange for the State and may, subject to availability of funding, perform any exchange 
functions necessary to ensure continued eligibility of citizens of this State for premium 
tax credits and cost-sharing reductions under Title I, Subtitle E, Part I of the federal 
Affordable Care Act. 
3.  Operation of certain exchange functions.  A state agency or department may 
operate any exchange function consistent with this section to enable the continuation of 
traditional areas of state regulation and authority.  Under Section 1311(d)(4)(A), (D), (F) 
and (K) of the federal Affordable Care Act, a state agency may perform plan management 
functions for the exchange, including plan certification, plan quality rating and related 
functions with respect to qualified health plans, and may operate consumer assistance 
functions to inform enrollees of their options and to enroll them in coverage. 
§7203.  Relation to other laws 
This chapter, and any action taken by the exchange, may not be construed to preempt 
or supersede the authority of the superintendent to regulate the business of insurance 
within this State.  Except as expressly provided to the contrary, all health carriers offering 
qualified health plans in this State shall comply fully with all applicable health insurance 
laws of this State and rules adopted and orders issued by the superintendent. 
Sec. 2.  Contingent effective date.  That section of this Act that enacts the Maine 
Revised Statutes, Title 24-A, chapter 93 does not take effect unless: 
1.  The United States Department of Health and Human Services, Internal Revenue 
Service or other department of the Federal Government notifies the State or citizens of 
the State or otherwise publicly declares that premium tax credits will become unavailable 
or are no longer available to individuals purchasing health insurance coverage through the 
federally facilitated marketplace established pursuant to the federal Patient Protection and 
Affordable Care Act, Public Law 111-48, as amended by the federal Health Care and 
Education Reconciliation Act of 2010, Public Law 111-152; and 
2.  The Superintendent of Insurance notifies the Secretary of State, the Secretary of 
the Senate, the Clerk of the House of Representatives and the Revisor of Statutes that, 
pursuant to subsection 1, notification has been received or public declaration has been 
made. 
SUMMARY 
This bill establishes the State's health benefit exchange as authorized by the federal 
Patient Protection and Affordable Care Act.  The bill specifies that the exchange's 
technical functions specified in the federal Patient Protection and Affordable Care Act, 
including but not limited to operation of the publicly accessible website, telephone 
hotline, cost calculator and exemption certification process, are to be operated by the 
Federal Government.  The bill authorizes state agencies and departments to interact and 
cooperate with the Federal Government with respect to the operation of the federally 
facilitated exchange for the State and to perform any exchange functions necessary to 
ensure that State residents have continued eligibility for premium tax credits and cost-
sharing reductions. 
The bill also clarifies that the Superintendent of Insurance retains authority to 
regulate the business of insurance within the State and that all health insurance carriers 
offering qualified health plans through the federally facilitated exchange must comply 
with all applicable health insurance laws of this State and rules adopted and orders issued 
by the superintendent. 
The provisions of this bill take effect only if the Federal Government notifies the 
State that premium tax credits will become unavailable to people purchasing health 
insurance through the federally facilitated marketplace.