By Andy O’Brien

On January 17, the Maine Legislature’s Health and Human Services Committee considered a bill that would provide more financial assistance for people with high medical bills. Current Maine law requires that free medical care must be provided to Maine residents with income less than 150% of the federal poverty level, which in 2023 was $21,870 a year for an individual and $45,000 for a family of four. However, patient advocates argue that the eligibility threshold needs to be raised to help more people who can’t afford the cost of healthcare.

According to a 2022 survey conducted by the nonprofit Consumers for Affordable Health Care, about half of Mainers with medical debt are not even aware that hospitals are required to provide medically necessary care for free to Mainers who meet certain income guidelines, and by the time many patients learn they qualify for low-cost care, it’s too late to apply for the program. Patients also aren’t always aware of what medical procedures are covered by the program, so they are shocked when they receive surprise bills for treatment they thought would be covered.

In addition, LD 1955 would require hospitals to more widely publicize information about financial assistance programs and make the information available in different languages. The bill also would simplify the application process for financial assistance, both to make it easier to apply and to extend the eligibility period for the program from six to 12 months. Finally, LD 1955 would make the program more transparent, so patients can understand what treatment is covered.

Selam Runyon-Baruch of the New Mainers Public Health Initiative, an organization that serves immigrant and refugee families, wrote in testimony about the bill that many of her organization’s community health workers have clients who have difficulties applying for free care. She said that some New Mainers end up being subject to debt collections procedures due to inadequate communication about what financial assistance covers. That stress of having medical debt can adversely affect their health, she added.

“Individuals with medical debt frequently struggle to satisfy basic needs – such as affording heat, groceries, gas, and childcare – resulting in negative consequences on overall health,” she wrote. “LD 1955’s objectives are consistent in reducing these effects and laying the groundwork for a healthier and more resilient community.”

Jeff Austin of the Maine Hospital Association, which represents the major hospitals in the state, submitted testimony that his organization was “not aware” of any problems with the existing law that needed to be fixed.

“The bill is a complete overhaul of charity care law and is the introduction for the first time of a regulatory scheme for financial assistance provided beyond charity care, such as payment plans,” he wrote. “It is extremely frustrating to see such a complete overhaul of a law administered by hospitals and for which hospitals carry the entire financial burden without any prior outreach.”