Affordable Health Insurance & Medicaid Expansion

Since 2014, Planned Parenthood has offered insurance counseling and enrollment in the Marketplace and MaineCare as a service for our patients. As the area’s largest reproductive and sexual health care provider, PPNNE proudly provides high-quality, affordable health care to more than 41,000 women, men, and teens each year, regardless of whether or not they have insurance. With forty percent of our patients paying for services out-of-pocket, in full or at a discounted rate, we understand that we were uniquely positioned to communicate about the Affordable Care Act, and connect more of our patients to insurance and other coverage options.

Accommodating our patients’ budgets and lifestyles is an essential part of our mission. Providing affordable, accessible care is a large part of improving the health of the communities we serve. The simple truth is that many of our patients would not have access to the health care system if we weren’t available to them. Connecting patients to essential health care coverage and advocating for expanded Medicaid benefits in the state of Maine are important components in making sexual health services more accessible and improving statewide health. 

OUR INITIATIVES & PROGRAMS

  • Marketplace Outreach & Enrollment: Certified Application Counselors (CACs) offer free help with Marketplace and Mainecare enrollment in our four health centers in Maine. We don’t limit this service to just our patients–it is available to anyone walking through our doors seeking assistance.
  • MaineCare Limited Family Planning Health Benefit: For the last few months we’ve been working closely with Department of Health and Human Services to roll out an important limited MaineCare benefit offering free sexual and reproductive health care to low come individuals. The Limited Family Planning Benefits was established in one of the failed veto bills during legislative session in 2015. Throughout October we’ve worked with our health center staff to begin enrolling walk-in patients in our health centers. Not only does this benefit cover any individual making under 24,000 per year, but it also means that Planned Parenthood in Maine will be able to receive reimbursement for many of the services we already give away for free. Covered services include: annual and well-woman exams, STI testing and treatment, HPV vaccines, pregnancy tests, cancer screenings, breast exams and more. This benefit offers relief for many of our clients who fall into a health coverage gap, and may not otherwise be connected to care.
  • Expanding Medicaid on the Ballot: Maine is one of 19 states as of July 2016 that has not adopted Medicaid Expansion as outlined by the Affordable Care Act. In fact, Maine has cut Medicaid funding and limited coverage to only categorically needy groups, making it difficult for many low-income folks to connect with any kind of health care coverage at all. Planned Parenthood Maine Action Fund supports Medicaid expansions and believes that the expansion of statewide free coverage for more low-income populations is an essential part to ensuring healthier, stronger, and more robust communities. On election day, we worked with a number of coalition partners like Maine People’s Alliance and Consumers for Affordable Healthcare to put Medicaid expansion on the ballot in 2018. Staff and volunteers at the polls collected over 70,00 signatures. We hope this will pressure the Maine legislature to consider Medicaid as an essential measure for Maine’s people.

OUR IMPACT

Getting covered has made a real difference in many of our patients’ lives. Individuals and families with insurance connect to critical care, they are more likely to get STI tested when needed, to take advantage of the ACA birth control benefit, which guarantees comprehensive coverage without a copay, and the peace of mind knowing that they won’t be denied coverage or charged more due to pre-existing conditions.

With the expertise we have at Planned Parenthood, our CACs are able to address the specific sexual or reproductive health insurance needs of our patients. For exmaple, Andy, a PPNNE patient receiving transgender care, shared their experience with our program and why they are forever grateful for the assistance we were able to provide. Andy has wrestled with gender identity since “I was four” and sought out PPNNE for help getting covered. Andy found the process easy. “With one appointment, I walked out having signed up for healthcare. PPNNE’s staff walked me through the process of finding out what constellation of coverage would work with my finances.” Finally insured, Andy was able to begin treatment for transitioning and sought care at PPNNE including our specialized transgender health care. “PPNNE welcomed me fully and with their help, transitioning has been easier and more rewarding than I had ever hoped. I now have a medical home that treats all of my needs.”

Today, Andy isn’t just a valued patient, they are also a star volunteer.

With three open enrollment periods successfully under our belt, we are excited to kick off our fourth, which began November 1, 2016 and ends February 1, 2017. We are also excited to be able to offer our patients a second level of coverage with enrollments in the Limited Family Planning Benefit as well. Based on income, family size and age, you may be eligible for tax credits to help cover the cost of health insurance coverage and we at PPNNE are here to help you decipher the options and like we did for Andy, find the option best for you. Contact a Certified Application Counselor for help at getcoveredME@ppnne.org.

 

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