Portland Press Herald from Portland, Maine • A7

Portland Press Saturday, November 17, 2012 A7 CYAN MAGENTA YELLOW BLACK ROP-PPH-TopBig-Right ed Edition: PD A7 Rundate: Saturday, November 17, 2012 ABOUT THE AUTHOR John Spritz is a marketing and communications consultant based in Portland, www.jspritz.com. Graphic by: Don Marietta, www.corofl ot.com/don_marietta CONTINUED FROM PAGE ONE EXCHANGE Continued from Page A1 nesses to shop for private coverage was anticipated. His administration and the outgoing Republican legislative major- ity stalled exchange implementation long enough that even supporters are wary of hastily cobbling one together by the Octo- ber 2013 deadline. According to an analysis by the Kaiser Family Foundation, states that run their own exchanges or partner with the federal government will have more control over which coverage plans will be available to consumers. States can also customize the plans to their health care needs.

Last year, an advisory panel comprised of insurers and hospitals unanimously recommended that the state create its own exchange. a federally run exchange you know what plans are going to be in Joe Bruno, a former Republican lawmaker who became chairman of the advisory commit- tee, told the Press Herald on Thursday. could end up with something cookie- cutter that just Eves said lawmakers would use the up- coming session to plan for a future state- based exchange. LePage is unlikely to support such efforts, but Eves noted that there was widespread support among Republicans and business leaders for a state-run exchange. Incoming Republican House leader Rep.

Kenneth Fredette of Newport said he ex- pects Democrats to submit bills advocat- ing for a state-based exchange and that Republicans would evaluate each one. When asked if he supported a state-based exchange, Fredette said he op- posed to one, but nitively say he would support one without rst seeing the details. Eves said he hoped Republicans would work with Democrats. initial conversations had with Rep. Fredette is that we are all approach- ing this in a similar Eves said.

have to gure out a way to get things done in general, so this could be a good place to Circumventing decree on Med- icaid expansion could prove more cult. Republicans generally believe that the tax- payer-funded program is cient and a state budget buster. The Obama administration and local Democrats argue the expansion makes sense politically and nancially. Originally, Medicaid expansion was a mandatory provision of Obamacare. The U.S.

Supreme Court this summer struck down the mandate, but millions in federal money remains for states that proceed with expansion. Eves said that forgoing expansion effec- tively means Maine would subsidize health care coverage for other states that allow the federal government to cover more of their residents. fact, we would be exporting our tax dollars to provide health coverage for people in any other state that decides to adopt the Medicaid he said. the 100 percent the government will pay for the rst two years, the feds will pay 90 percent after. That is a bargain when talking about paying for thousands of health care.

a bad business decision to forgo that LePage the only governor to pass on Medicaid expansion. Six other Repub- lican governors have said nitively that taking a pass, while ve others are leaning in that direction, according to an analysis by The Advisory Board Company, a health-care consulting rm. Maine could become the only holdout in New England. New Hampshire has indi- cated that likely to participate while Massachusetts, Connecticut, Vermont and Rhode Island have already committed to expansion. States that agree to expansion would extend Medicaid eligibility to nearly all individuals with incomes up to 133 percent of the federal poverty level.

A single person earning as much as $14,856 a year would receive health insurance, and a family of three earning as much as $25,390 would be covered, according to statistics compiled by the Kaiser Family Foundation. Advocates for expansion argue that in- creased Medicaid eligibility saves money because it would discourage needy resi- dents from getting charity care in hospital emergency rooms. Charity care is often funded through higher premiums for those with private insurance. Charity care is also a concern for hospi- tals. Uncompensated care health care costs that hospitals absorb because people or pay soared nationally from a total of less than $5 billion to nearly $40 billion from 1980 to 2010, according to the Ameri- can Hospital Association.

The Portland Press Herald reported that uncompensated care by Maine hospitals has more than doubled over the past ve years, from $94 million to $194 million. unclear whether decision is supported by the Maine Hospital Associa- tion, the trade group representing hospitals. A spokesman for the group did not immediately return a call seeking com- ment. Jeffrey Austin, a spokesman for the group, told the Press Herald in July that increased Medicaid eligibility would lower costs for uncompensated care, but hospitals often end up paying for expanded Medicaid pro- gramming through reduced federal reim- bursements. However, at the time, Austin said the as- sociation may still end up advocating for the expansion.

Staff Writer Steve Mistler can be contacted at 791- 6345 or at: STATE EXCHANGES VERSUS FEDERAL EXCHANGES Exchanges are Web-based marketplaces mandated in the Affordable Care Act where individuals and small businesses will choose health insurance plans starting in 2014. The exchanges also allow people to see whether they qualify for subsidies based on individual or family income. Each state must establish and operate an exchange, or the federal government will set one up for the state. States not willing or able to set up their own exchange in time also will have an opportunity to collaborate with the federal government. Federal exchanges will be a somewhat standard model from state to state.

State exchanges will allow more opportunity for customized operations and services, many experts say. A rural state such as Maine could create regional ces to serve consumers, or provide more services by phone for people who do not have Internet service, for example. States that choose to run their own exchanges or partner with the federal government also will have more control over which plans to offer to consumers. A state such as Maine with high childhood asthma rates could require insurers in its exchange to include asthma management in their plans. Both state and federal exchanges will operate with outside funding, including fees from insurance companies, although some fear state-run exchanges will require more public funding to operate.

And some, including Gov. Paul LePage, say state-run exchanges will be so tightly regulated that there will be little advantage for states to establish their own. a federally run exchange you know what plans are going to be in it. You could end up with something cookie-cutter that just JOE BRUNO former Republican lawmaker The Associated Press KANSAS CITY, Mo. A south- west Missouri man accused of plotting to shoot up a movie the- ater during the new lm was charged Friday after his mother contacted police, telling them she worried her son had purchased weapons similar to those used during the fatal Colorado theater shooting.

Blaec Lammers, 20, of Bolivar, is charged with rst-degree as- sault, making a terroristic threat and armed criminal action. He was jailed in Polk County on $500,000 bond. we had a responsi- ble family member or we might have had a different Bolivar Police Chief Steve Ham- ilton told The Associated Press. He said Lammers is under a care for mental illness, and court documents said he was of his A phone message left by The Associated Press at home returned Friday. No attorney is listed for him in online court records.

His mother contacted authori- ties Thursday, saying she wor- ried that with this opening of the nal lm in the popular Vampire movie series, her son have intentions of shooting people at the police wrote in the probable cause statement. She said she thought the weapons two assault es and hundreds of bullets resembled those used by a gunman who opened re inside a theater in Aurora, during the latest Batman movie in July. That at- tack killed 12 people. Lammers was questioned Thursday afternoon and told authorities he bought tickets to a Sunday screen- ing in Bolivar and planned to shoot people inside the theater. The town of 10,000 people is 130 miles southeast of Kansas City.

According to the probable cause statement, Lammers also planned to start shooting people at at a Walmart store less than a mile away. He said purchased two assault es and 400 rounds of ammuni- tion, and if he ran out of bullets, he would break the glass where the ammunition is being stored and get some more and keep shooting until police ar- investigators wrote. Lammers stated he wanted to stab a Walmart employee to death and followed an employee around a Walmart store before cers got involved in 2009, ac- cording to police. Missouri man, 20, admits he planned a massacre at a screening of call may have averted theater shooting CRASH Continued from Page A1 was locally based. The crash occurred about 4: 45 p.m., after sunset, but North- graves said he know if darkness was a factor.

The sky was clear and winds were light, according to the Na- tional Weather Service. John Newcomb, president of Down East Air, who went to the scene to try to help, told The As- sociated Press that another pilot saw the impact, and emergency workers were quickly sum- moned. With ames shooting 10 to 20 feet in the air, the rst people at the scene tried unsuccessfully to pull one of the occupants from the wreckage, which sent smoke billowing into the sky, Newcomb said. Heat from the ames popped the tires and kept rescuers away from the plane, he said. The AP reported that the air- port was the site of the deadli- est commercial plane crash in Maine history, in 1979.

More than a dozen passen- gers and two pilots were killed when a de Havilland Twin Otter turboprop crashed short of the runway in foggy weather. There was only one survivor, a 16-year- old boy. Staff Writer Edward D. Murphy can be contacted at 791-6465 or at:.