Health Care Reform Farewell in Maine


Maine gets credit for being first in line (seven years ago) in attempting to tackle health care reform. At one point during the national debate, it was viewed as a model to emulate. Its Dirigo plan, however, never lived up to expectations and appears headed for the scrap heap. Stateline reports:

Before there was a federal health care overhaul, and before there was a Massachusetts law to use as a model for the national plan, there was Dirigo. That’s what Maine called its first-in-the-nation attempt at achieving universal health coverage when Democrats approved the plan back in 2003.

Now, the Maine program may be one of the first casualties of the Republican landslide in state capitals. Maine’s incoming governor, Paul LePage, pledged during the campaign to “repeal and replace” the plan, which is Latin for “I lead” and is the state’s motto. Republicans also took control of the Maine House and Senate, making the state one of only two to flip from total Democratic control to total control by Republicans (Wisconsin was the other).

Dirigo was the brainchild of outgoing Governor John Baldacci, who sought to dramatically increase coverage for the uninsured while lowering the costs associated with hospital care. A key to the program was encouraging small businesses to buy coverage for their employees by making plans affordable and subsidizing coverage for individuals and families on a sliding scale based on income.

But the program faced battles over funding from the start. In 2007, Maine capped enrollment for two years until lawmakers could agree on a funding fix. The problem was further complicated when voters in 2008 rolled back the tax on soda and alcohol that the Legislature figured would pay for Dirigo. Even its supporters admit the program has never lived up to its promise of serving as many as 180,000 of Maine’s 1.2 million residents by 2009.

LePage, a Tea Party favorite, has called Dirigo “a costly failure.” He claims taxpayers have spent more than $160 million to cover just 3,400 uninsured Mainers under the program. Baldacci’s administration disagrees with that portrayal, arguing that since it began, Dirigo has covered more than 32,000 people without using any general fund dollars to pay for it.

Under a complicated funding arrangement, Dirigo is funded 50 percent by the “savings offset payment” from private insurance companies. That’s the amount the state figures insurers are saving because the uninsured aren’t seeking emergency care they can’t pay for. The rest of the funding comes from premiums, the federal government and tobacco settlement dollars.

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