By Michael Shepherd - April 7, 2022
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Good morning from Augusta. It's Opening Day (not for the Red Sox) and that is a great thing. Here's your soundtrack for the real start of spring.

What we're watching today

A huge dispute between the state's biggest hospital and the insurer Anthem is reverberating across the state. Maine's top story on Wednesday was Maine Medical Center's move to drop Anthem from in-network coverage as of Jan. 1, 2023. Patients insured by Anthem will still be able to get treatment there, but it will likely be more expensive. MaineHealth, the Portland hospital's parent, is staying with the state's biggest insurer at other hospitals and medical offices across the state.

Hospital officials cited $70 million in nonpayment from Anthem for services over the last three years and said the insurer is also withholding $13 million in annual payments. Anthem's side of the story is that it had flagged concerns about "unilateral increases" in charges at Maine Medical Center, although the Maine Hospital Association says other members are having similar problems. A December survey found $350 million in outstanding debt from Anthem.

The move is seismic. Gov. Janet Mills urged the sides to return to the negotiating table, saying this "should be avoided at all costs." State employees also get their health coverage through Anthem, making this a major issue of interest for policymakers and union officials. Past that, Steven Michaud, the president of the Maine Hospital Association, told the Bangor Daily News that more hospitals could follow Maine Medical Center in dropping Anthem.

It highlights the state's heavy reliance on a relatively small number of insurers. Anthem has 300,000 customers in Maine across all insurance products from private policies to state government and the Affordable Care Act marketplace. It controlled nearly 70 percent of Maine's large-group market in 2019, according to the Kaiser Family Foundation. That share put Maine in the top half of states most beholden to one insurer in that part of the market.

That is why this is such a major issue. Any sustained period of nonpayment can threaten the state's health care system in an outsized way. If the state's biggest hospital has to sever its relationship with the dominant insurer, health coverage is only going to get more complicated for people in southern Maine and others across the state who may have to be sent there for specialized care.

News and notes

— The U.S. Senate is expected to confirm Ketanji Brown Jackson to the Supreme Court on Thursday with the help of Sen. Susan Collins and two other Republicans who are breaking ranks to support President Joe Biden's nominee. The bipartisan support is scant when you compare it to a long history of easy high-court nominations that have become more fraught in recent years, but it is what Democrats hoped for when they began this process.

— Just when we thought Mal Leary was done under the dome, he was pulled back in. The dean of the State House press corps until his retirement from Maine Public last summer was appointed this week by House Speaker Ryan Fecteau, D-Biddeford, to represent broadcasting interests on the Right to Know Advisory Committee. He will serve out the term of Suzanne Goucher, the longtime CEO of the Maine Association of Broadcasters who died in January.

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What we're reading

— Lifesaving COVID-19 pills are being underused in parts of Maine. Some health centers are seeing supplies of oral antiviral medications sit amid a lack of interest in them. A Rockport man credits Paxlovid with quickly turning back his symptoms shortly after testing positive, though he had to travel to get it.

— The real estate shortage is also hitting lots selling in the millions of dollars with no house included. There are 50 such properties on the market in Maine now, from 99 forested acres in Yarmouth ripe for developers who can pay $6 million to a $2.95 home lot along a private golf course in Biddeford, but real estate agents say it is not enough to meet demand.

— Maine is spending millions to bail out veterans homes in Caribou and Machias but only just beginning to come up with a long-term plan for them. The homes were slated for closure until Mills and the Legislature passed emergency aid. Maine Veterans Homes says the aid will only solve part of their problems. Staff shortages, for example, cannot be easily fixed by legislation.

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Follow along today

10 a.m. The House and Senate are in. The calendars are long as the chambers prepare to begin meeting every weekday through the scheduled end of the 2022 session in roughly two weeks.

In the House, a vote could come on a bill that would tie stricter standards to the sales of major Maine utilities that split the energy committee. Watch here.

The Senate may vote on bills that would shield access to records on certain eviction and small-claims court actions and rein in the use of non-disclosure agreements in employment. Watch here.

1 p.m. The housing committee will review final proposed versions of Fecteau's signature housing reform bill. It has been voted on by the committee but has not gone to the chamber floors yet. Watch here.

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📷 Lead photo: A masked woman walks by Maine Medical Center's south entrance in Portland on Feb. 10, 2021. (BDN photo by Troy R. Bennett)

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