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April 7, 2010 Jay Finegan, 287-1445
Rep. Strang Burgess: New law assures insurance will be there when needed

AUGUSTA – State Rep. Meredith Strang Burgess said a new law regarding health insurance will prevent financial ruin for Mainers experiencing costly medical bills.

The new statute, based on LD 1620, prohibits a cap on annual or lifetime benefits in insurance policies covering Maine residents. It passed both houses of the Legislature unanimously on March 26 and was signed into law by Governor Baldacci on April 1. The law takes effect for all policies issued or renewed after January 1, 2011.

“This law will give Mainers the confidence that their insurance coverage will remain in place during medical emergencies,” said Rep. Strang Burgess (R-Cumberland), who co-sponsored the legislation. “More than half of all health insurance plans sold in Maine cap lifetime benefits, and most people have no idea what the cap is.”

Rep. Strang Burgess said she was disturbed by the story of Theresa D’Andrea, of Limerick, whose husband, Richard (“Rocky”), was diagnosed with advanced skin cancer in 2008. His treatment plan involved the drug Proleuken, which cost $9,000 per dosage. With four doses required in every 24-hour period, his health care bills were piling up at a rate of $36,000 a day. When Rocky D’Andrea reached the lifetime cap of $250,000, the couple went deeply in debt to continue the treatment. He died on March 22, leaving his widow with $60,000 in unpaid medical bills.

“As a cancer survivor myself, I was really troubled by the D’Andreas’ story,” said Rep. Strang Burgess, who serves on the Health and Human Services Committee. “Fortunately, very few Mainers ever exceed their lifetime caps. The Portland Press Herald reported that only 14 Mainers had reached their lifetime caps in the last 20 years. But with caps in place, there’s always the possibility of bankruptcy in cases of health catastrophes.”

The new Maine law allows some exceptions for specific types of health insurance plans, such as those designed for part-time or seasonal workers. The law requires that any health policy offered after the effective date include a notice of a permitted time of coverage.

The federal health care overhaul also eliminates lifetime caps within a year and annual caps by 2014.

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