DirigoChoice
April 21, 2009 -
In my last email, I asked you for your comments on health care in Maine.
Click here to read some of the responses.
Last week, the Insurance and Financial Services Committee heard several bills on health care in Maine. On Friday, April 17th, we had work sessions steeped in health care, especially the DirigioChoice program. DirigoChoice is Maine's four-year-old state-subsidized health care program. When it was founded, the program had expectations to cover 131,000 Mainers by delivering affordable and accessible quality health care. Unfortunately, the program has spent more time in the courts fighting for its funding stream than covering Maine's uninsured.
The major focus for Dirigo is to find a sustainable funding stream. LD 1206, "An Act To Fund the Dirigo Health Program through a High-risk Pool," was one of the bills we heard on the subject. LD 1206 would require medical insurers to pay an assessment of up to $10 per person per month to support the costs of high-risk people and subsidize costs for Dirigo Health. This bill would also require Dirigo Health enrollees to complete health assessments as a condition of receiving subsidies, and would repeal the guaranteed issuance requirement for individual health insurance.
Another bill we heard was LD 1264 "An Act to Stabilize Funding and Enable DirigoChoice to Reach More Uninsured." LD 1264 would require the Board of Trustees of Dirigo Health to reach more uninsured and underinsured individuals through a more affordable product. The bill requires changes to be made in DirigoChoice and replaces the savings offset payment, currently assessed at a variable rate up to 4% of paid claims determined each year depending on savings, with a fixed 2.14% access payment on paid claims paid monthly.
So, what will happen to DirigoChoice? I believe DirigoChoice will continue operating and covering enrolled Mainers. Right now, there are about 9,500 Mainers covered, and that number will dwindle to about 5,000 by next summer as a result of people choosing not to re-enroll. The funding stream will most likely change to something like the health access surcharge presented in LD 1264, and then the program will have the $43 million or so to increase the number of the enrollees to 12,000-15,000.
