An Act to Lower
Maine Legislature, Session 132, LD 2196
Committee Amendment CA_B_H1034 (House)

COMMITTEE AMENDMENT "^ " to H.P, 1475, L,D. 2196, "An Act to Lower
Health Insurance Costs, Reduce BarrielFs to Health Care and Ensure Fair Prices for Health
Care"
Amend the bill by striking out the title and substituting the following:
'Resolve, to Establish the Commission to Study Health Insurance Costs and Fair
Pricing in Health Care'
Amend the bill by striking out everything after the title and insertmg the following:
'Emergency preamble. Whereas, acts and resolves of the Legislature do not
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, this resolve establishes the Commission to Study Health Insurance Costs
and Fair Pricing in Health Care; and
Whereas, the study must be initiated before the expiration of the 90-day period in
order to provide sufficient time for the study to be completed and a report submitted in time
for submission to the next legislative session; and
Whereas, in the judgment of the Legislature, these facts create an emergency within
the meaning of the Constitution of Maine and require the following legislation as
immediately necessary for the preservation of fhe public peace, health and safety; now,
therefore, be it
Sec. 1. Commission established. Resolved: That the Commission to Study
Health Insurance Costs and Fair Pricing in Health Care, referred to in this resolve as "the
commission," is established to study the drivers of rising health insurance premiums and
health care costs in the State and recommend policy solutions that improve the cost of care
while protecting access to needed services and maintaining a stable health care system.
Sec. 2. Commission membership. Resolved: That, notwithstanding Joint Rule
353, the commission consists of the following 22 members:
1. Nine members appointed by the President of the Senate as follows:
COMMITTEE AMENDMENT
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COMMITTEE AMENDMENT « j<<" to H.P, 1475, L.D. 2196
A. Two members of the Senate, including one member offhe party holding the largest
number of seats in the Legislature and one member of the party holding the 2nd largest
number of seats in fhe Legislature;
B. One member representing large health care systems;
C, One member representing physicians and other clinical providers;
D. One member representing behavioral health providers;
E. One member representing public health professionals;
F. One member representing large employers;
G. One member representing a consumer advocacy organization; and
H. One health economist;
2. Nine members appointed by the Speaker of the House as follows:
A. Two members of the House of Representatives, including one member of the party
holding the largest number of seats in the Legislature and one member of the party
holding the 2nd largest number of seats in the Legislature;
B. One member representing rural or critical access hospitals;
C. One member representing community health centers;
D. One member representing aursing home providers;
E. One member representing commercial health insurers;
F. One member representing small businesses;
G, One member representing patients or families impacted by health care affordability
challenges; and
H. One actuary; and
3. The following members, serving in ex officio capacity:
A. The Superintendent of Insurance or the superintendent's designee;
B, The Commissioner of Health and Human Services or the commissioner's designee;
C, The executive director of the Maine Health Data Organization or fhe executive
director's designee; and
D. The executive director of the Office of Affordable Health Care or the executive
director's designee.
Sec. 3. Chairs. Resolved: That the first-named Senate member is the Senate chair
and the first-named House of Representatives member is the House chair of the
commission.
Sec. 4. Appointments; convening of commission. Resolved: That all
appointments must be made no later than 30 days following the effective date of this
resolve. The appointing authorities shall notify the Executive Director of the Legislative
Council once all appointments have been completed. After appointment of all members,
the chairs shall call and convene the first meeting of the commission, which must be no
later than 30 days following the appointment of all members. If 30 days or more after the
Page2-132LR2841(03)
COMMITTEE AMENDMENT
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COMMm-EE AMENDMENT "^" to H.P. 1475, L.D. 2196
effective date of this resolve a majority of but not all appointments have been made, the
chairs may request authority and fhe Legislative Council may grant authority for the
commission to meet and conduct its business.
Sec. 5. Duties; meetings. Resolved: That the commission shall examine cost
drivers across the health care system, including health care delivery, insurance markets,
pharmaceutical spending, workforce costs, regulatory stmctures and social determinants
affecting the use of the health care system. In its examination, the commission shall:
1. Engage stakeholders, including patients and families, health care providers,
employers, labor organizations, rural communities, tribal leaders, pharmacy representatives
and behavioral health providers;
2. Analyze drivers of health care and health insurance costs and evaluate major
contributors to rising premiums and health care costs, including hospital and health system
costs, physician and clinical services, pharmaceutical prices, administrative costs, health
insurer practices, workforce patterns and labor costs, usage patterns and population health,
market consolidation and competition and the impact of federal and state policies;
3. Examine state-specific market factors and structural issues, including rural health
care delivery challenges, the States aging population, small risk pools, workforce
shortages, high chronic disease burden, cost shifting between payers, Medicaid and
Medicare reimbursement levels, commercial insurance reimbursement levels, employer-
sponsored insurance trends, patient boarding in acute care beds and emergency departments
and regional and population-specific health care needs;
4. Compare the State to other rural states regarding population, hospital payer mix and
health care infrastmcture; and
5, Develop policy recommendations and produce actionable recommendations,
including, but not limited to, short-tenn and long-term structural reforms, market
transparency, payment reforms, workforce strategies, prevention and population health
investments and regulatory reform,
Sec. 6. Staff assistance. Resolved: That the Legislative Council shall provide
necessary staffing services to the commission, except that Legislative Council staff support
is not authorized when the Legislature is in regular or special session.
Sec. 7. Report. Resolved: That, no later than November 4, 2026, fhe commission
shall submit a report that includes its findings and recommendations, including suggested
legislation, to the joint standing committee of the Legislature having jurisdiction over
health and human services matters and to the joint standing committee of the Legislature
having jurisdiction over health coverage, insurance and financial services matters. The
committees are each authorized to report out legislation related to the report of the
commission to the 133rd Legislature in 2027.
8 Emergency clause. In view of the emergency cited in the preamble, fhis legislation
takes effect when approved,'
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section
number to read consecutively.
COMMITTEE AMENDMENT
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COMMITTEE AMENDMENT " K^" to H.P. 1475, L.D. 2196
SUMMARY
This amendment, which is the minority report of the committee, replaces the bill with
a resolve. It establishes the Commission to Study Health Insurance Costs and Fair Pricing
in Health Care. The commission consists of 22 members and is directed to study the drivers
of rising health msurance premiums and health care costs in M:aine and recommend policy
solutions that improve the cost of care while protecting access to needed services and
maintaining a stable health care system. The commission must submit a report that includes
its findings and recommendations, including suggested legislation, to the joint standing
committee of the Legislature having jurisdiction over health and human services matters
and to the joint standing committee of the Legislature having jurisdiction over health
coverage, insurance and financial services matters. The committees are each authorized to
report out legislation related to the report of the commission. The amendment adds an
emergency preamble and emergency clause,
FISCAL NOTE REQUIRED
(See attached)
COMMITTEE AMENDMENT
Approved; 04/01/26
t-RL
LD 2196 LR 2841(03)
An Act to Lower Health Insurance Costs, Reduce Barriers to Health Care and Ensure Fair Prices for
Health Care
Fiscal Note for Bill as Amended by Committee Amendment "(2,'/'H-)
Committee: Health and Human Services
Fiscal Note Required: Yes
Fiscal Note
Legislative Cost/Study
Legislative Cost/Study
The general operating expenses of this study are projected to be $1,400 in fiscal year 2025-26 and $1,650 in fiscal
year 2026-27. The Legislature's budget for the 2026-2027 biennium includes $7,253 in fiscal year 2025-26 and
$17,696 in fiscal year 2026-27 for the costs of legislative studies, as well as $41,338 of balances carried over from
prior fiscal years for this purpose, Whether these amounts are sufficient to fund all studies will depend on the number
of studies authorized by the Legislative Council and the Legislature. The additional costs of providing staffing
assistance to the study during the interim can be absorbed utilizing existing budgeted staff resources,
Fiscal Detail and Notes
Additional costs to departments and agencies participating in the work of the commission are assumed to be minor and
can be absorbed within existing budgeted resources,
LR2841(03) - Fiscal Note - Page 1 of 1