The Maine Legislature is considering several bills designed to chip away at Public Law 90. This 2010 law, passed by the then-Republican majority after a rushed review and compressed debate, deregulated the small group and individual health insurance markets, and it subsidized private insurers through a fee levied on all insured people in the state.

Inspired by a similar deregulation effort in Idaho, the bill’s sponsor, then- Rep. Jon McKane, R-Newcastle, said, “[The] 60-year-old in Idaho is paying the same amount as a 20-year-old in Maine. If that doesn’t say we should do something, I don’t know what will.”

So why is the Legislature now contemplating the repeal of central components of PL 90? Are we moving closer to the Idaho model, as predicted? Indeed, we are. Insurance premiums are cheaper for some. For others, especially rural Mainers, premiums are skyrocketing, putting health coverage out of reach.

According to the Kaiser Family Foundation, in 2011, 10 percent of Mainers were uninsured, while 18 percent of people in Idaho were. By August of last year, about 21 percent of people in Idaho were uninsured. But rates of health care coverage are not equal across Idaho: Rural and remote counties are driving the problem. In remote and rural Clark and Owyhee counties, for instance, 32 percent of residents have no health insurance.

This rural-urban divide unveils PL 90’s flaw: It reduces rates for a few by jacking up rates for others. Maine is the most rural state in the nation and also the oldest. This is no surprise, as the economic policies of the past 40 years have spurred a migration out of rural America, leaving the oldest behind. Before PL 90, Maine protected rural residents by imposing “rating bands” on private insurers. This meant that the oldest rural customers could not be charged premiums more than 1.5 times what a young urban resident would pay for the same policy. So, if a base premium was $300, an older Mainer would pay $450.

Since PL 90, the age factor is 3-to-1, the geographic factor is 1.5-to-1 and the tobacco-use factor is 1.5-to-1. But in yet another departure from the past, these factors can be piled on top of each other rather than combined. Now, if the lowest premium rate available to a young nonsmoker in Cumberland County is $300 per month, the highest monthly premium for an older smoker in Aroostook County can be a staggering $2,025 per month. For some perspective, annual per capita income in Aroostook is $20,659 — or $1,721 a month.

What PL 90 allows private corporations to do is “cherry-pick” the healthiest customers — young and urban Mainers — by offering tantalizingly low rates. At the same time, companies can unload the old, sick and rural by spiking their rates to unaffordable levels.

Since PL 90’s enactment, premium rates increased for the majority of all small businesses but most dramatically in northern and eastern Maine. In the fourth quarter of 2012, the Maine Bureau of Insurance reported that almost 87 percent of small group policyholders in northern Maine faced a rate increase — some as high as 80 percent. Not surprisingly, the Maine Bureau of Insurance also reported that small group renewals are decreasing. People cannot afford to renew their insurance. The percentage of uninsured in Maine has increased since the passage of PL 90: By October 2012, 11.5 percent of Mainers were uninsured.

PL 90 also shrank the state’s role in overseeing rate increases in the individual market and created a “high-risk pool” via a $4-per-month tax on all insured people in Maine. This tax is handed over to private insurers, to reimburse them for care they provide to people they identify as “high-risk”: $22 million annually. Did this reduce premiums, as predicted? Only for a few, as we have seen.

Did it result in newer, cheaper products entering the market, as PL 90’s champions predicted? Anthem offers a new product, Health Choice Plus, which sets up a maze of hefty deductibles for in-network care, out-of-network care and prescriptions, and eliminates maternity benefits — yet another tool to keep costs down by squeezing out expensive people (that is, women of childbearing age).

What, then, should our representatives do to ensure that rural Mainers can still afford health insurance? We can say that we have tried deregulation, just as the federal government experimented pre-2008 with deregulating the giant banks. We can say that our experiment is complete. The result is plain to see in the evidence of staggering rate hikes and reduced policy renewals.

The optimal fate for PL 90 would be complete repeal, but this is unlikely to survive Gov. Paul LePage’s veto pen. Surely, as the most rural state, we should ensure that our rural and older residents are protected against rate increases, both by reinstating reasonable ratings bands and ensuring public oversight. The $4 monthly tax should no longer be handed over to private companies without oversight.

So, yes, we are following the Idaho model, to a place where old, rural Mainers will be much more likely to be uninsured. Is this good public policy?

Isn’t the role of insurance to spread risk across a population, not concentrate costs among the oldest and the sickest among us? After all, as my Ashland-born grandfather used to intone, “Old age comes to us all.”

Let us once again show leadership to craft a path for Maine that honors our unique rural spirit and is fair and humane to the oldest and most vulnerable among us. My grandfather’s wisdom should humble the most ardent proponent of deregulation: It is an inescapable part of the human condition that someday you will age and become frail.

Christy Roix Daggett is a Presque Isle native and a graduate student in public policy at the Edmund S. Muskie School of Public Service at USM. She is a graduate fellow of the Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications.

There can be little doubt we face worrisome times. This may be especially the case for those who believe that the government bears responsibility for responding to those who have genuine need and have earned the right to expect some assurance of well-being late into life. That expectation may appear to be at risk, altered by forces that could change the rules of the game in midstream. The forces are powerful, unmistakable and certainly unsettling — sequestration, incessantly bickering political parties, calls for less government (code, in some cases for fewer services, entitlements and benefits that have helped insure citizen safety, health and overall quality of life).

Americans began turning 65 years of age at the astounding rate of 10,000 a day since January of 2011. Americans will continue to celebrate their 65th birthdays at this unprecedented pace for the next 20 years as the baby boomer generation grows older. Are older Americans a force to be reckoned with? In terms of their absolute numbers, you certainly would think so. They are more than 40 million strong — projected to grow to an unprecedented 72 million by 2030. Talk about a group with the potential for displaying game changing clout.

Yet, the ability of older adults to assert their influence in concerted fashion remains a question mark. Elders have never been of a single mentality when they vote perhaps because elders are as diverse as any other age group – probably more so given the accumulation of varying life experiences over a lifetime. And, in some respects, the 65-plus population may have less voice than any other group. The current generation of older adults remains, by and large, extremely well behaved and well mannered. Rarely picketing, boycotting or voting unresponsive politicians out of office and responsive ones in.

Older adults will not be listened to — at least not to the degree they should — until they decide to show their true strength in more visible ways. Given their inherent difference of opinion on issues, elders are not likely to vote with anything approximating a single voice (like the growing Hispanic population displayed in the last national election.)

To be sure, we have first-rate professional elder advocates in our midst that represent organizations and associations locally and nationally who speak on behalf of older citizens. They lobby for needed legislation, services and other supports that will insure quality of life for older Mainers and their families. Older adults who are incapacitated or overwhelmed by life circumstances count on them. However, those efforts should not preclude or substitute for the responsibility we each have to take responsibility and express ourselves on issues that we feel strongly about and affect us, our families and the communities we live in.

How can older adults ensure their voices are heard? There are a number of straightforward steps to be taken. Consider writing letters to the editor of your local newspaper and to your city, state and federal government officials. Spend a day at the capitol, meeting with your local legislators and expressing your views on issues of concern. Go to town hall and city council meetings and keep abreast of issues in the community. Take advantage of available technology and express your views on the many special issue blogs and discussion forums. Volunteer to present testimony at public hearings considering new legislation and policy. If time allows, and you are so inclined, consider running for an elected position on your local town council, planning board or even state Legislature. Also, make it your business to sit on the boards and advisory councils of organizations in your community that deal with issues of personal interest.

There is a lesson to be learned from the Grey Panthers, a group of feisty individuals led by Maggie Kuhn, who were retiring from national religious and social work organizations and met for the first time in the Philadelphia area in August of 1970 to look at common problems faced by retirees – loss of income, loss of jobs and loss of contact with colleagues. They realized early on that growing older was accompanied with a new kind of freedom – the freedom to speak their minds – personally and passionately about what they believed in.

The Grey Panthers have done that ever since through local networks across the U.S. Kuhn believed that “power should not be concentrated in the hands of so few and powerlessness in the hands of so many.” The Grey Panthers were among the original troublemakers serving in Maggie’s view as “watch-dogs” that “bark” when danger is near. The Grey Panthers remain committed to honoring maturity, unifying the generations, advocating for active engagement and promoting participatory democracy.

I am convinced many Mainers in their 60s and beyond have a little Grey Panther in them itching to break free. Armed with the personal and professional experiences that have accumulated over a lifetime, their wisdom would serve our communities well at the same time that it informs our decision makers as they consider legislation and policy that is going to impact our lives and those of generations to follow.

Regardless of your point of view or political affiliation, you have the right to be heard. Take a lesson from Kuhn who believed that “old age is an excellent time for outrage.” Her goal was to “say or do one outrageous thing every day.” If you are growing old in the state of Maine, your time is now.

Lenard W. Kaye is a professor at the University of Maine School of Social Work and director of the University of Maine Center on Aging. He is a member of the Maine chapter of the national Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week This Op-Ed was adapted from an article appearing in the Winter 2013 issue of Maine Seniors Magazine.

 

Over concern that larger increases will have negative effects on employment, most minimum wage proposals call for only modest increases. A bill recently proposed by Rep. Scott Hamann, D-South Portland, would increase Maine’s minimum wage only $1, from $7.50 to $8.50, with subsequent increases indexed to inflation.

A better approach, recommended by the Center for Budget and Policy Priorities, would be to simultaneously raise the minimum wage and expand the state’s Earned Income Tax Credit, a program that supplements the wages of low- and moderate-income workers. Such a combined approach would more effectively help the working poor and spread the cost of helping more broadly, allaying concerns that larger minimum wage hikes would adversely affect a slowly recovering economy.

Raising the minimum wage, while expanding the EITC, magnifies the effect beyond what each policy does separately. Alone, a minimum wage hike raises the take-home pay of workers more, but since the EITC increases as income increases, in tandem the two policies raise the income of eligible workers even more.

Additionally, because each policy targets different types of workers, together they reach more working poor. Those most positively affected by an increased minimum wage are those working in part-time jobs and in service occupations — typically young and less educated workers. The EITC targets workers with children. Poor single mothers — among the poorest of the working poor — will especially benefit from the combined approach since they are more likely to be working in part-time jobs, often in service occupations and, as parents, have higher income limits under the EITC.

While on balance research indicates that the negative effects of a minimum wage increase on employment are relatively small, more modest and phased increases will give businesses — especially small businesses — a chance to adjust and absorb the increased wage bill.

While large businesses such as Wal-Mart — among those most often paying minimum wage — will be able to cover the increase out of thick profit margins for the most part, small businesses will need to cut production costs to offset the higher wage bill. Innovative business owners will do things such as conserve energy use, streamline production processes to cut waste, better train their workers to help them be more productive and offer non-wage incentives to encourage higher productivity.

Smaller increases in the minimum wage — enabled by a simultaneous expansion in the EITC — will make these adjustments more manageable, which in turn should help diminish any negative employment effects.

A combined approach also spreads the cost of helping the working poor more broadly across the private and public sectors. The burden of a minimum wage increase is borne by employers, stockholders and consumers and those workers who may see their hours cut or their chances of being hired reduced. The burden of an expanded EITC will depend on how the state makes up for the lost revenue.

Expanding the EITC increases the progressivity of the overall income and payroll tax system, but if the state offsets lost revenues by cutting spending or raising regressive sales taxes, the benefits to low- and moderate-income households will not be realized.

Since wealthy households and large businesses have on average seen their situation substantially improve over the last several decades, and most have weathered the recent economic downturn easily enough, it would be fairer to offset lost revenues with increased taxes on the wealthy and highly profitable businesses. Because the combined approach spreads the burden of helping the working poor more broadly, it should make a progressive approach more politically feasible.

Maine is one of 24 states that supplements the federal EITC with its own EITC. The federal EITC and most state EITCs are fully refundable, meaning when the credit exceeds the amount of taxes owed, the worker receives the difference as a refund. Maine’s EITC is only 5 percent of the federal EITC and is not refundable.

The EITCs in nearby Vermont, Massachusetts, Connecticut, Rhode Island and New York are more generous and all are either fully or partially refundable. Maine also has one of the lowest minimum wage rates in the region; only New Hampshire’s and New York’s are lower, at $7.25. Maine has room to both increase its minimum wage and expand its EITC program and still be in line with nearby states.

Median wages in real terms have been falling for decades. With more and more employers turning to contingent work arrangements in response to an increasingly competitive economy, involuntary part-time and temporary work are increasing. The gap between the wealthy and the rest is growing, and upward economic mobility is stalling. While not the whole reason, stagnating wages and increased use of contingent work arrangements are part of the reason.

A two-pronged approach to raise the minimum wage and expand the state’s EITC will more effectively and equitably rectify this economic imbalance.

Lisa A. Morris is an assistant professor at the University of Southern Maine’s Muskie School of Public Service, where she teaches economics and public policy and is the coordinator of the Policy Analysis Track. She is a member of the Maine chapter of the national Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.

As we begin to feel the effects of the recent partisanship-induced sequestration, the American political system seems to be utterly incapable of cooperation and compromise. A shutdown of the federal government is possible later this month; another debt ceiling battle looms on the horizon in May. We seem poised to bounce from one frustrating crisis to another, with little hope for cooperation between Democrats and Republicans.

Yet alongside these dispiriting developments, bipartisan cooperation is under way on another important issue.

Lost in the gloomy headlines of the past several weeks, there was a rare instance of cooperation in a sketch for comprehensive immigration reform, reached by prominent U.S. Senate Democrats and Republicans. Accompanying the plan is an ambitious timeline. Legislation will be introduced by early April, move through the Senate, and the hope is that the package is brought to a vote in advance of the August recess in the House.

This tentative outline lays out four main objectives: creating a path to citizenship for at least some of those in the U.S. illegally; ensuring a more effective employee verification system; fine-tuning of immigration enforcement to meet economic needs while also protecting immigrant children and families; and devising a system of admitting future workers on a temporary or conditional basis.

Immigration reform is badly needed. Prominent attempts at comprehensive reform in 2006 sparked massive protest by mistakenly treating immigration solely as a security issue. Immigration policy is not simply about longer, more secure fences or more Border Patrol agents. It’s about finding ways to harmonize border security with humane policies that are fairly enforced. In addition, it’s about devising policies that recognize the benefits that flow from immigrant communities to the American economy, our society and our culture.

This particular reform push presents a rare opportunity in which there are strong incentives for politicians and lawmakers in both parties to reach agreement, ideally before the 2014 midterm elections. Prominent Democrats have been pledging to successfully broker an immigration reform package for years. In fact, President Barack Obama pledged to bring about comprehensive reform in the initial year of his first term. Thus far, Democrats have been unable to deliver.

Among Republicans, the last presidential election was a frightening wake-up call. Mitt Romney captured just 21 percent of the Latino vote, and Latinos shifted the balance in key swing states such as Florida, Ohio and Colorado. The Latino electorate is projected to double in the United States by 2030. If the Republicans cannot begin speaking to Latino voters on issues that matter to them, such as immigration, they will suffer stinging electoral defeats in years to come.

While successful bipartisan cooperation in Washington would help shore up many Americans’ beleaguered faith in their political system, this issue has practical importance for Maine. Maine has a significant and rising percentage of immigrant business owners, workers and students, who contribute millions of dollars to our economy and enrich the diversity of our communities and our state.

A recent report on Maine by the American Immigration Council put it best, stating that “at a time when the economy is in a slump, Maine can ill-afford to alienate an important component of its labor force, tax base, and business community — especially since the state’s population is aging rapidly and growing number of retirees are depending on a declining number of workers.” The report vividly details the ways in which immigrant populations are already positively shaping Maine’s future.

While immigration reform has a difficult path ahead, particularly in the House of Representatives, we must praise and support those lawmakers willing to engage in the difficult business of negotiation and compromise on this important issue.

Robert W. Glover is the CLAS-Honors Preceptor of Political Science at the University of Maine where his research focuses on the politics of immigration in the United States. He is a member of the Maine Regional Network, part of the Scholars Strategy Network, which brings together scholars across the country to address public challenges and their policy implications. Members’ columns appear in the BDN every other week.