An Act To Lower Health Care Costs
Maine Legislature, Session 129, LD 2110
Committee Amendment CA_A_S441 (Senate)
Amends: 5 MRSA §12004, 3 MRSA §1023

COMMITTEE AMENDMENT "A" to S.P. 755, L.D. 2110, Bill, "An Act To 
Lower Health Care Costs" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 3 MRSA c. 39 is enacted to read: 
CHAPTER39 
OFFICE OF AFFORDABLE HEALTH CARE 
§1021. Definitions 
1. 
Advisory council. 
"Advisory council" means the Advisory Council on 
Affordable Health Care established in Title 5, §12004-I, subsection 31-B. 
2. Director. "Director" means the director of the office. 
3. Legislative oversight committee. "Legislative oversight committee" means the 
joint standing committee of the Legislature having jurisdiction over health coverage 
matters. 
4. Office. "Office" means the Office of Affordable Health Care established in 
section 1022, subsection 1. 
§1022. Office of Affordable Health Care 
1. Office established. The Office of Affordable Health Care is established for the 
purpose of analyzing health care costs in this State in accordance with the duties set forth 
in this chapter and as provided in this section. 
2. Director; appointment. The Legislative Council shall appoint by an affirmative 
vote of 8 members of the Legislative Council a nonpartisan director for the purposes set 
forth in this chapter. The director must be appointed to an initial 5-year term, which is 
subject to renewal by the Legislative Council every 5 years thereafter. During the term of 
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the contract, the director may be terminated only for cause by an affirmative vote of 8 
members of the Legislative Council. 
The Legislative Council shall establish the 
compensation of the director. 
3. Duties. The office's duties must be performed independently and in a nonpartisan 
manner but under the general policy direction of the legislative oversight committee and 
the advisory council. The office shall report at least annually to the legislative oversight 
committee pursuant to section 1025 and upon request of the legislative oversight 
committee on matters affecting the cost of health care in this State. The office shall, at a 
minimum, use data available from the Maine Health Data Organization, established 
pursuant to Title 22, chapter 1683, and the Maine Quality Forum, established in Title 
24-A, section 6951, to: 
A. Analyze health care cost growth trends and correlation to the quality of health 
care; 
B. Analyze health care spending trends by consumer categories payer type, provider 
categories, or any other measurement that presents available data in a manner that 
may assist the legislative oversight committee in understanding health care cost 
drivers, health care quality and utilization trends, consumer experience with the 
health care system or any other aspect of the health care system; 
C. Monitor the adoption of alternative payment methods in this State and other states 
that foster innovative health care delivery and payment models to reduce health care 
cost growth and improve the quality of health care; 
D. Based upon the data obtained and the analysis pursuant to paragraphs A to C, 
develop proposals for consideration by the legislative oversight committee on 
potential methods to improve the cost-efficient provision of high-quality health care 
to the residents of this State; 
E. Develop proposals for consideration by the legislative oversight committee on 
potential methods to improve consumer experience with the health care system, 
including the provision of a consumer advocacy function on health care matters not 
addressed by the Health Insurance Consumer Assistance Program established in Title 
24-A, section 4326 or the Department of Professional and Financial Regulation, 
Bureau of Insurance, Consumer Health Care Division established in Title 24-A, 
section 4321; and 
F. Provide staffing assistance to the Maine Prescription Drug Affordability Board 
established in Title 5, chapter 167, at the request of the board and with the approval 
of the Legislative Council. 
4. 
Data; confidentiality. 
Data provided to the office under subsection 3 is 
confidential to the same extent it is confidential while in the custody of the entity that 
provided the data to the office. 
5. Supervision; employees. The director shall supervise the staff of the office in 
accordance with policies adopted by the legislative oversight committee and consistent 
with the policies of the Legislative Council. The director shall prepare and present a 
biennial budget to the Legislative Council for its approval. Employees of the office must 
be nonpartisan. Employees of the office are employed by and are responsible to the 
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director, who shall hire and fix the compensation of each employee, subject to the 
approval of the Legislative Council and within resources available in the biennial budget. 
6. Coordination with other entities. The director may contract with individuals or 
entities and may seek assistance and coordinate efforts in accordance with this chapter 
with other agencies or divisions of State Government and with other entities as long as 
the contract, assistance or coordination does not present a conflict of interest. For the 
purposes of this subsection, "conflict of interest" means an association, including a 
financial or personal association, that has the potential to bias or have the appearance of 
biasing the office's decisions or the conduct of the office's activities. 
§1023. Advisory Council on Affordable Health Care 
The Advisory Council on Affordable Health Care, established in Title 5, section 
12004-I, subsection 31-B, is an advisory council to the office on matters affecting the cost 
of health care in this State. 
1. Duties of advisory council. The advisory council shall advise the office on 
matters affecting the cost of health care in this State. 
2. Membership. The advisory council consists of 10 members as follows: 
A. Eight members of the advisory council appointed as follows, subject to review by 
the legislative oversight committee and confirmation by the Senate: 
(l) Four members appointed by the President of the Senate, including one 
member who represents hospital interests, one member who represents primary 
care provider interests, one member who represents the interests of older 
residents of this State and one member who represents a health care consumer 
advocacy organization; and 
(2) Four members appointed by the Speaker of the House, including one member 
who represents health insurance interests, one member who represents purchasers 
of health care, one member with demonstrated expertise in health care delivery, 
health care management at a senior level or health care finance and 
administration and one member who represents the health care workforce; and 
B. At the invitation of the President of the Senate and the Speaker of the House, 2 ex 
officio nonvoting members: 
(1) The Commissioner of Health and Human Services or the commissioner's 
designee; and 
(2) 
The Commissioner of Administrative and Financial Services or the 
commissioner's designee. 
3. Terms of office. Appointed members of the advisory council serve 5-year terms 
and may be reappointed. A vacancy for an unexpired term must be filled in accordance 
with subsection 2, paragraph A or B. 
A member may serve until a replacement is 
appointed and qualified. 
4. Chair; vice-chair. The advisory council shall annually elect a chair and a vice-
chair from among its members. 
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5. Quorum. Five voting members of the advisory council constitute a quorum. 
6. Affirmative vote. An affirmative vote of a majority of the voting members is 
required for any action taken by the advisory council. 
7. Meetings. The advisory council shall meet at least once every 2 months and may 
also meet at other times at the call of the chair. Meetings may be cancelled or postponed 
at the discretion of the chair. All meetings of the advisory council are public proceedings 
within the meaning of Title 1, chapter 13, subchapter 1. 
8. Recusal. A member of the advisory council with a conflict of interest shall elect 
to be recused. For purposes of this subsection, "conflict of interest" means any instance 
in which a member, staff member or contractor of the advisory council or an immediate 
family member of the member. staff member or contractor of the advisory council has 
received or could receive either of the following: 
A. A direct financial benefit of any amount deriving from the results or findings of a 
study or determination by or for the advisory council; or 
B. 
A financial benefit from individuals or companies that own or manufacture 
prescription drugs or health care services or items to be studied by the advisory 
council that in the aggregate exceeds $5,000 per year. 
For purposes of this 
paragraph. "financial benefit" includes honoraria, fees, stock or other financial benefit 
and the current value of already existing stock holdings, in addition to any direct 
financial benefit deriving from the results or findings of a study or determination by 
or for the advisory council. 
§1024. Annual public hearing 
Beginning in 2020, the office shall convene an annual public hearing on cost trends 
no later than October 1st annually. The hearing must provide an opportunity for public 
comment on health care cost trends. 
The advisory council. the legislative oversight 
committee and the director shall preside over the hearing. 
§1025. Annual report 
No later than January 1, 2021 and annually thereafter, the office shall submit an 
annual report to the legislative oversight committee and the advisory council of its 
findings in accordance with this chapter. 
The report must include a summary of 
comments received at the annual public hearing convened under section 1024. 
Sec. 2. 5 MRSA §12004-1, sub-§31-B is enacted to read: 
31-B. 
Health Care 
Advisory Council on 
Expenses Only 
MRSA §1023 
Affordable Health Care 
Sec. 3. Annual reports for 2021 and 2022. The annual reports due pursuant to 
7 
the Maine Revised Statutes, Title 5, section 1025 for the calendar years 2021 and 2022 
8 
must include, in addition to the requirements contained in section 1025, recommendations 
to the joint standing committees of the Legislature having jurisdiction over health 
coverage, insurance and health and human services matters regarding how to ensure 
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appropriate public health infrastructure throughout the State and how to develop the most 
effective consumer resource for health care issues that extend beyond access to health 
insurance coverage. 
Sec. 4. Staggered terms; Advisory Council on Affordable Health Care. 
Notwithstanding the Maine Revised Statutes, Title 3, section 1023, subsection 3, of the 
members initially appointed to the Advisory Council on Affordable Health Care, 3 
members must be appointed to serve initial terms of 2 years, 3 members must be 
appointed to serve initial terms of 3 years and 2 members must be appointed to serve 
initial terms of 4 years. 
o 
Sec. 5. Appropriations and allocations. 
The following appropriations and 
allocations are made. 
OFFICE OF AFFORDABLE HEAL TH CARE 
Office of Affordable Health Care N344 
Initiative: Appropriates funds for the costs of one Director, Office of Affordable Health 
Care position and one Legislative Analyst position within the new Office of Affordable 
Health Care beginning August 1, 2020. 
GENERAL FUND 
2019-20 
2020-21 
POSITIONS-LEGISLATIVE COUNT 
0.000 
2.000 
Personal Services 
$0 
$221,560 
All Other 
$0 
$20,000 
GENERAL FUND TOTAL 
$0 
$241,560 
SUMMARY 
This amendment replaces the bill. 
The amendment establishes the Office of 
Affordable Health Care within the Legislature. The office is charged with analyzing data 
from the Maine Health Data Organization and the Maine Quality Forum and making 
recommendations to the joint standing committee of the Legislature having jurisdiction 
over health coverage matters on methods to improve the cost-efficient provision of high-
quality health care to the residents of this State. The office is required to hold an annual 
public hearing on cost trends no later than October 1st annually at which the public may 
comment on health care cost trends. The office is required to submit an annual report. 
The office is independent and nonpartisan, and the legislative committee and an 
advisory council provide advice on matters affecting health care costs in the State. The 
advisory council consists of 8 appointed members, including a member who represents 
hospital interests, a member who represents primary care provider interests, a member 
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who represents a health care consumer advocacy organization, a member who represents 
health insurance interests, a member who represents purchasers of health care, a member 
who represents the health care workforce, a member who represents the interests of older 
residents of this State and a member with demonstrated expertise in health care delivery, 
health care management at a senior level or health care finance and administration. The 
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Commissioner of Administrative and Financial Services and the Commissioner of Health 
and Human Services are ex officio members of the advisory council. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
.. pproved: 03/15/20 ;:wac 
LD 2110 
LR 2890(02) 
An Act To Lower Health Care Costs 
Fiscal Note for Bill as Amended by Committee Amendment f" (j-'-14{) 
Committee: Health Coverage, Insurance and Financial Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2019-20 
FY 2020-21 
$0 
$241,560 
$0 
$241,560 
Projections 
FY 2021-22 
$255,785 
$255,785 
Projections 
FY 2022-23 
$264,813 
$264,813 
Provides an appropriation of $241,560 in fiscal year 2020-21 for the costs of one Director, Office of Affordable 
Health Care position and one Legislative Analyst position within the newly created Office of Affordable Health Care 
beginning August 1, 2020. 
Any additional costs to the Department of Health and Human Services and the Department of Administrative and 
Financial Services to serve on the Advisory Council are expected to be minor and can be absorbed within existing 
budgeted resources. 
LR2890(02) - Fiscal Note - Page 1 of 1