Maine LD 1617: An Act To Create A Single-Payer Health Care Program In Maine

Bill Text

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An Act To Create a Single-payer Health Care Program in Maine
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 5 MRSA c. 167 is enacted to read:
CHAPTER 167
MAINE SINGLE-PAYER HEALTH CARE PROGRAM
� 2041. Establishment
The Maine Single-payer Health Care Program, referred to in this chapter as "the program," is established to provide for the health care of residents of this State. The program must be designed in accordance with the requirements of this chapter and may not be implemented before January 2022 as provided in this chapter.
� 2042. Design of program

1. Design requirements. The Department of Health and Human Services, in consultation with the Department of Labor and the Department of Professional and Financial Regulation, Bureau of Insurance, shall design the program to provide coverage for health care services from participating providers within the State if those services are necessary or appropriate for the prevention, diagnosis or treatment of, or maintenance or rehabilitation following, injury, disability or disease. At a minimum, the program must provide:

A. Coverage for the following health care services:

(1) Hospital services;

(2) Medical and other professional services furnished by participating providers;

(3) Laboratory tests and imaging procedures;

(4) Home health care for residents of the State requiring services performed by or under the supervision of professional or technical personnel, including, but not limited to, home health care for acute illness, personal care attendant services and the medical component of home health care for chronic illness;

(5) Rehabilitative services for residents of the State receiving therapeutic care;

(6) Prescription drugs and devices;

(7) Mental health services;

(8) Substance use disorder treatment;

(9) Primary and acute dental services;

(10) Vision appliances, including lenses, frames and contact lenses;

(11) Medical supplies, durable medical equipment and selected assistive devices; and

(12) Hospice care;

B. Delivery of covered health services through organized delivery systems;

C. Payment for covered health care services provided to a resident while the resident is in the State or out of the State. The program must pay for a reasonable amount charged for medically necessary emergency health care services; and

D. Fair rates of compensation with participating providers and organized delivery systems and negotiation with pharmaceutical companies for similarly classified pharmaceuticals.
� 2043. Implementation

1. Implementation. Upon enactment of authorizing legislation establishing financing for the program, the State shall implement the program in phases as required in subsections 2 to 4.

2. Phase one. Beginning in January 2022, the State shall provide coverage through the program for a resident of the State who is not eligible for coverage under the MaineCare program and who has an income that is below 250% of the federal poverty level.

3. Phase 2. No later than January 2024, the State shall provide coverage through the program for a resident of the State who has an income between 250% and 400% of the federal poverty level.

4. Phase 3. No later than January 2026, the State shall provide coverage through the program for a resident of the State who has an income above 400% of the federal poverty level.

5. Waiver; request for federal approval. The Department of Health and Human Services and any other affected department or agency of the State shall apply for all waivers, exemptions and approvals from the Federal Government that are necessary to fully implement the program.
For the purposes of this section, "federal poverty level" means that measure defined by the federal Department of Health and Human Services and updated annually in the Federal Register under authority of 42 United States Code, Section 9902(2).
Sec. 2. Single-payer Implementation Task Force. The Single-payer Implementation Task Force, referred to in this section as "the task force," is established to oversee planning and implementation of the Maine Single-payer Health Care Program, established in the Maine Revised Statutes, Title 5, chapter 167, as follows.
1. Appointments; composition. The task force consists of members appointed as follows:
A. Four members of the Senate, appointed by the President of the Senate, including 2 members of the party holding the largest number of seats in the Senate and 2 members of the party holding the 2nd largest number of seats in the Senate, of whom at least one member is a member of the Joint Standing Committee on Health Coverage, Insurance and Financial Services, at least one member is a member of the Joint Standing Committee on Health and Human Services and at least one member is a member of the Joint Standing Committee on Labor and Housing or