The Maine Medical Association hopes to keep Maine out of the fight to repeal national health care reform.

Leaders of the association, which represents Maine physicians, plan to meet with Gov.-elect Paul LePage or his staff and incoming Attorney General William Schneider and urge them not to join at least 20 other states in a legal challenge, according to Gordon Smith, the association’s executive vice president.

Even a limited repeal of the most controversial piece of the Affordable Care Act — a mandate that individuals buy insurance — could jeopardize other hard-won benefits of the law, such as higher Medicaid reimbursements and better coverage of preventive care, Smith said.

“We are alarmed that people are talking about repealing it without looking at each of the provisions that might be good for Maine and Maine patients,” he said.

Smith said the MMA’s board of directors voted Wednesday to take the stand, and he had not yet asked for meetings with the incoming administration or attorney general.

The MMA appears to be the first sector of Maine’s health care industry to come out either for or against the repeal effort. Members of the medical industry, including insurance carriers, have opposed the repeal in other parts of the country.

LePage said early this month that he plans to ask the incoming attorney general to join the health care reform lawsuit against the federal government.

And Schneider, a Republican from Durham, has said he believes the federal law is unconstitutional, and that he is considering whether the state should join a repeal lawsuit in Florida.

Schneinder could not be reached to comment for this story.

Dan Demeritt, spokesman for LePage, said the Republican governor-elect will listen.

“Paul LePage is generally open to speak with anyone, so I’m sure he’d be happy to hear from the MMA and consider their views,” Demeritt said.

But he said the incoming governor has philosophical and constitutional objections, especially about the mandate that individuals buy insurance.

“It comes down to a philosophy about individual choice and competition and market forces,” Demeritt said. “The governor-elect believes if we give consumers more freedom to make choices, there will be opportunity to bring costs down.”

Smith, of the MMA, said he’s confident that the law doesn’t violate the Constitution, in part because public subsidies will ensure that the insurance is affordable.

There are parts of the law that doctors don’t like, Smith said, but there also are positive changes that have taken years to achieve.

Under the law, for example, many doctors — especially in rural areas — will see chronically low Medicaid reimbursements go up in 2013, and the federal government will pay for the increase, Smith said.

“That’s huge for our ability to continue care in rural areas,” he said.

While the legal challenge in Florida is focused on the part of the law that requires individuals to buy insurance, a repeal could unravel the entire law because the other parts are based on near universal coverage, Smith said.

“It took us an awful lot of effort to get where we are,” he said. “Maybe we’re naive, but we believe if the Maine health care community sits down with (the incoming governor and attorney general) that, in fact, we could convince them that Maine should not join the litigation in support of repeal, that it’s not good for Maine; it’s not good for Maine patients.”

Even as the incoming administration weighs a challenge of the law, the state is moving forward with implementing reform.

Two state committees that have been putting together an implementation plan will hold a public hearing Tuesday in Augusta.

Trish Riley, outgoing director of the Governor’s Office of Health Policy, said it’s unclear where the repeal efforts will lead or what will happen to the rest of the law if the individual insurance mandate is struck down.

“It doesn’t necessarily kill the whole law. It certainly makes it more difficult,” she said.

The LePage administration and the Republican-led Legislature won’t have time to simply wait and see what happens with the repeal efforts because the state has to put new insurance rules and programs in place before the requirements take effect in 2014.

“The federal government will be ready to put (them) in place for states that aren’t ready,” Riley said. “Most governors would prefer to do things at the state level than have the federal government come in and do it.”

Staff Writer John Richardson can be contacted at 791-6324 or at:

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