The Legislature’s Banking and Insurance Committee holds a public hearing today on L.D. 1745. Beneath the bland State House title, “An Act to Address Issues in the Maine Health Insurance Market,” beats the heart of a casino gambler. If Maine catches some breaks, the bill, a product of the King administration’s Bureau of Insurance, just might increase competition in a health-insurance market now essentially lacking any competition whatsoever. If that happens, it might make insurance more affordable to healthy young adults with children, it might make affordable insurance available to more employers and individuals.

Those are the “ifs.” The dead certainty is that it will allow insurers to charge their older and sicker customers more, if not drive them out of the private market entirely and into publicly funded or charity care.

The bill essentially undoes Maine’s community-rating laws, decade-old legislation that has been a model for nearly every other state. By establishing a standard rate based upon the health-care costs of a large cross-section of middle-age persons, community rating caps the differential that can be charged based upon age, geographic region or occupation. It allows higher rates for smokers; it prohibits higher rates based upon health status or gender.

The bureau’s proposal, part of a sprawling bill that should be several bills, changes the definition of community rating in a way that also redefines the basic concept of insurance as a shared risk by a large cross-section of society- it divides society into age-group “families.” Under current law, the oldest person in a health plan can be charged only 50-percent more than the youngest. With this change, the difference could double. The same for those with pre-existing conditions.

The administration proposal removes the rating based upon smoking status and replaces it with a factor called “healthy lifestyle.” Given the importance of such things as diet, exercise and alcohol use on health, this broader definition seems wise. Unfortunately, the definition and level of benefit is left for the insurance companies to decide and the danger that a discount for a “healthy lifestyle” could become a surcharge for an imperfect “health status” is real.

Of course, the governor’s insurance bureau does not propose these changes to drive Maine’s elderly from the rolls of the insured and its sick into their graves. The bill’s great failing is that it attempts a rational resolution to an irrational situation.

The stark truth is that Maine, with the collapse or pull-out of several insurers and the sale of Blue Cross/Blue Shield to Anthem has no competition in health insurance. The steady erosion of benefits and the increasing co-pays and deductibles continue, the burden upon families, business and taxpayers is crushing. At the same time, Maine residents – young and middle-aged residents – continue to indulge in one of the nation’s most unhealthy lifestyles, as its high smoking and obesity rates attest.

The gamble that higher rates for the sick and elderly will result in lower rates for everyone else must include the longest of odds.