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Cross posted at Dirigo Blue





Maine's new health insurance reform law enacted by the Legislature this spring (24-A MRSA Chapter 54-A) created a high-risk pool, known as the Maine Guaranteed Access Reinsurance Association. Essentially, people with expensive chronic illnesses can be pushed off their current coverage and into the high-risk pool, which is administered by the State.

What is of interest is that many parts of Chapter 54-A are taken verbatim from model legislation crafted by the American Legislative Exchange Council (ALEC). This in-depth primer on ALEC will provide background on the organization, but is short it is a group funded and run by corporations and conservative interests that writes bills that are then given to like-minded legislators to introduce in their home states.

The model legislation on which Chapter 54-A is based can be found here. Here are some comparisons:

From Section 2 of the ALEC bill:

(E) “Insurer” means any entity that is authorized in this state to write health insurance or that provides health insurance in this state. For the purposes of this act, the insurer includes an insurance company, nonprofit health care services plan, fraternal benefits
society, health maintenance organization, third party administrator, state or local governmental unit, to the extent permitted by federal law any self insured arrangement covered by Section 3, Employment Retirement Income Security Act of 1974 (29 U.S.C. Section 1002), as amended, that provides health care benefits in this state, any other entity providing a plan of health insurance or health benefits subject to state insurance regulation, and any reinsurer or stop-loss plan providing reinsurance or stop-loss coverage to a health insurer in this state.

And Chapter 54-A §3952.6.:

"Insurer" means an entity that is authorized to write medical insurance or that provides medical insurance in this State. For the purposes of this chapter, "insurer" includes an insurance company, a nonprofit hospital and medical service organization, a fraternal benefit society, a health maintenance organization, a self-insured employer subject to state regulation as described in section 2848-A, a 3rd-party administrator, a multiple-employer welfare arrangement, a reinsurer that reinsures health insurance in this State, a captive insurance company established pursuant to chapter 83 that insures the health coverage risks of its members, the Dirigo Health Program established in chapter 87 or any other state-sponsored health benefit program whether fully insured or self-funded.

From Section 7.(B) of the ALEC bill:

(2) enter into contracts that are necessary to carry out this article including, with the approval of the commissioner, entering into contracts with similar pools in other states for the joint performance of common administrative functions or with other organizations for the performance of administrative functions;

(3) sue or be sued, including taking any legal actions necessary or proper to recover or collect assessments due the pool;

(4) institute any legal action necessary to avoid payment of improper claims against the pool or the coverage provided by or through the pool, to recover any amounts erroneously or improperly paid by the pool, to recover any amount paid by the pool as a mistake of fact or law, and to recover other amounts due the pool;

And Chapter 54-A §3955.2.:

B. Enter into contracts as necessary or proper to carry out the provisions and purposes of this chapter and may, with the approval of the superintendent, enter into contracts with similar organizations of other states for the joint performance of common administrative functions or with persons or other organizations for the performance of administrative functions;

C. Sue or be sued and may take legal actions necessary or proper to recover or collect assessments provided in section 3957 due the association;

D. Take legal actions necessary to avoid the payment of improper claims against the association or the coverage provided by or through the association, to recover any amounts erroneously or improperly paid by the association, to recover amounts paid by the association as a result of mistake of fact or law or to recover other amounts due the association;

From Section 9. (Option One) of the ALEC bill:

(A) For the purposes of providing the funds necessary to carry out the powers and duties of the pool, the board of directors shall assess member insurers at such time and for such amounts as the board finds necessary. Assessments shall be due in not less than 30 days after prior written notice to the member insurers and shall accrue interest at twelve percent per annum on and after the due date.

(B) Each insurer shall be assessed in an amount not to exceed Two Dollars ($2.00) per covered person insured or reinsured by each insurer per month.

(C) The board shall make reasonable efforts designed to ensure that each covered person is counted only once with respect to any assessment. For that purpose, the board shall require each insurer that obtains excess or stoploss insurance to include in its count of covered persons all individuals whose coverage is insured (including by way of excess or stoploss coverage) in whole or in part. The board shall allow a reinsurer to exclude from its number of covered persons those who have been counted by the primary insurer or
by the primary reinsurer or primary excess or stoploss insurer for the purposes of determining its assessment under this section.

And Chapter 54-A §3957.:

1. Assessments. For the purpose of providing the funds necessary to carry out the powers and duties of the association under section 3955, the board shall assess insurers at such a time and for such amounts as the board finds necessary. Assessments are due not less than 30 days after written notice to the insurers and accrue interest at 12% per annum on and after the due date.

2. Maximum assessment. The board shall assess each insurer an amount not to exceed $4 per month per covered person enrolled in medical insurance insured, reinsured or administered by the insurer. An insurer may not be assessed on policies or contracts insuring federal or state employees.

3.  Determination of assessment.   The board shall make reasonable efforts to ensure that each covered person is counted only once with respect to an assessment. For that purpose, the board shall require each insurer that obtains excess or stop loss insurance to include in its count of covered persons all persons whose coverage is insured, in whole or in part, through excess or stop loss coverage. The board shall allow a reinsurer to exclude from its number of covered persons those who have been counted by the primary insurer or by the primary reinsurer or primary excess or stop loss insurer for the purpose of determining its assessment under this subsection. The board may verify the amount of each insurer's assessment based on annual statements and other reports determined to be necessary by the board. The board may use any reasonable method of estimating the number of covered persons of an insurer if the specific number is not reported.

Looks like Maine Republicans took the opportunity to double the $2 fee that ALEC suggested.

Feel free to look for other similarities - let us know what you find.

Originally posted to Dirigo Blue on Thu Sep 01, 2011 at 01:30 PM PDT.

Also republished by Exposing ALEC.

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Comment Preferences

  •  If you're writing about ALEC please feel (18+ / 0-)

    free to steal the logo at the top of this and use on your posts.

    Form follows function -- Louis Sullivan

    by Spud1 on Thu Sep 01, 2011 at 11:18:00 AM PDT

  •  Bill Matching. (8+ / 0-)

         It's not easy but it's something we can all do in every state.

    •  Maine hasn't seen the influence (6+ / 0-)

      of ALEC as much as other states have, but that doesn't mean their presence isn't felt. The House Majority Whip, Andre Cushing, "had a terrific time at the ALEC conference in New Orleans".

      Cushing hopes to be Maine's next Speaker of the House.

      Form follows function -- Louis Sullivan

      by Spud1 on Thu Sep 01, 2011 at 02:37:56 PM PDT

      [ Parent ]

      •  .and met Arthur Laffer and learned about economics (3+ / 0-)

        God help Mainers.

        I looked at some of this guy's background.

        I suspect that he's never taken an economics course and has never met or listened to any talks given by any actual economists. Laffer is the only name he dropped. He learned about ways to address Maine's economic problems. Yeah. Right.

        Running a state economy based on hearing a talk by Arthur Laffer is like following investment advice from Bernie Madoff.

        I'm at a loss here. I don';t think you can fix such deeply ingrained stupidity. Cushing seems to be impressed only because he recognized two names; Laffer and Raygun. Apparently, this is all he needs.

        Maybe if Cushing knew that Laffer voted for Clinton in 1992 and 1996 he wouldn't worhip Laffer any more.

        Managing a state economy deals with budgets and allocating funds. It is micro-economics. Macro economic theory is a completely unrelated subject. I would bet big money that Laffer couldn't balance a check book.

        Arthur Laffer, Pete Peterson, and so many other fake economists are frauds and con artists. The economists that came up with these discredited abstract theories begrudgingly changed their views later in life and embraced Keynesian economic theory. Laffer now claims that he derived his imaginary theory by extending Keynes work. This is complete bullshit.

        But none of this matters. If an ignorant state legislator wants to reduce taxes for himself and his friends, then anything that spins this into a positive message will be used. It works best when they add fear and end-of-the-world urgency into the mix.

        We can't fix these con artists, but we can educate some of the voters. I think that this is the only approach that has a chance.

        ALEC is a non-partisan educational organization, my ass.

        I believed in Santa Claus at one time, too.

        "All people are born alike - except Republicans and Democrats" - Groucho Marx

        by GrumpyOldGeek on Thu Sep 01, 2011 at 03:55:12 PM PDT

        [ Parent ]

    •  Bill Matching is Time Consuming (6+ / 0-)

      Great job on this - I know how much time something like this takes to complete.

      Great job! and thanks for sharing - you are an inspiration to others to do the same.

      Thanks for sharing!  It is so important!

      •  This is a great piece... (1+ / 0-)
        Recommended by:
        AnnieJo

        ... of work and can appreciate the amount of work it requires.

        Thanks for leading the charge in Maine, it gives others just a small taste of how prevalent ALEC models are in other States, with much longer and recently more ambitious plans for the replacement of 'citizen government' for corporate 'government in a box' supported by ALEC a major political service provider to the mega-wealthy and corporate interests.

        Great work Spud.

  •  All these ALEC bills... (7+ / 0-)

    ...are the privitization of the legislature.  Democracy personified weaps.

  •  The next thing to do is to find out who the (3+ / 0-)
    Recommended by:
    Hector Solon, AnnieJo, Bob Sloan

    public and private members of the ALEC Task Force who wrote this "Model Legislation" are, and which of their specific economic interests get advanced when a state pass one of their bills and then identify those who get screwed by the passage of ALEC "Model Legislation".

    A word about ALEC and Republican messaging.  When we accept their terminology that an ALEC bill is a "Reform" bill, then they have already won part of the argument.  When a Republican says "Reform" he/she means "Destroy" or "Ravage" the public good they intend to "Reform".  This "model legislation" is intended to destroy or hamper implementation of one of the important parts of the Patient's Affordable Health Care Act, which they mischaracterize as "ObamaCare", which of course is meant to be a pejorative by their Luntzian wordsmiths.

    We have to take the language back, and we have to quit accepting Republican/ALEC framing, because that hands them a rhetorical victory.

    Since I mentioned the Health and Human Services Task Force, here is a link to the home page of this group.  Note the titles of the articles "ObamaCare" comes up in one, the legislation in question comes up as Arizona developed, and copied by ALEC, and the Private Task Force Chair is identified as Marianne Eterno of Guaranted Trust Life Insurance Company, and the Public Chair is Senator Leah Vukmir of Wisconsin.

    They won't disclose anyone else on the Task Force, but people all over America are digging up their names, and are smoking out their economic interests that without fail, are to be paid for by the American people who are not so fortunate to be ALEC Task Force members.

    Here is another tidbit from the ALEC Health and Human Services Task Force home page.  It is a publication titled The State Legislator's Guide to REPEALING OBAMACARE.  Do you need anything else to determine their intentions?  In this case "Reform" means "Repeal" and replace it with nothing, which is exactly what we had before the legislation was passed.

    Republicans are like alligators. All mouth and no ears.

    by Ohiodem1 on Thu Sep 01, 2011 at 07:30:03 PM PDT

    •  Right on... (3+ / 0-)
      Recommended by:
      AnnieJo, Bob Sloan, Ohiodem1

      ... the models are one of the early steps (along with tracking members and ALEC activities in a State), the next steps are to look at the ALEC State Chair and their PAC money, the donations and contributions trails, the co-sponsors and their relationships. Identification of models leads to new investigations and that is also time consuming.

      We need to continue to develop experience and tools to make model ID'ing easy, so folks on the local and state levels can focus on the most corrupt portion of the ALEC supported 'system', following the money and who benefits from the displacement of State laws with corporate designed legislation.

      They can't hide this stuff, it's everywhere and in hundreds of historical documents.

      "Every dime, every crime, all directions, all the time, Exposing ALEC, our new pastime."

  •  I have a suggestion for all Kossacks that are (0+ / 0-)

    wanting to do a comparison between state legislation and ALEC's model legislation - and if you try this you'll find it works well.
    Take a portion of the ALEC model legislation - I took this:

    (E) “Insurer” means any entity that is authorized in this state to write health insurance or that provides health insurance in this state. For the purposes of this act, the insurer includes an insurance company, nonprofit health care services plan, fraternal benefits
    society, health maintenance organization, third party administrator, state or local governmental unit, to the extent permitted by federal law any self insured arrangement covered
    and plugged it into Google Search.  I found numerous hitson this and see that Connecticut, Texas and several others states have proposed or enacted legislation contain much similar wording.

    Try this with other model legislation and see what you come up with.  Know it sounds primitive, but it identifies similar legislation by state and provides proof of ALEC's involvement.

    "Inmates should be reformed - not recycled" http://piecp-violations.com/

    by Bob Sloan on Fri Sep 02, 2011 at 09:14:48 AM PDT

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