State Expansions: Maine
In June 2003, Governor Baldacci signed Maine's Dirigo Health Plan into law. The act was designed to ensure that every Mainer has access to affordable, quality health care by 2009.
In 2007, the governor proposed a set of significant reforms to the program, including individual and employer mandates and a new reinsurance pool. The governor also planned to phase out community rating, meaning that insurers would be able to vary premiums based on health status and claims history. Baldacci's measures were included in LD 1890, but the bill did not pass before the end of the 2007 legislative session.
Before the end of the 2007 session, the legislature passed LD 431, which allows Dirigo Health to self-administer rather than contract with a private insurance company. The state did end its contract with Anthem (a private insurer), but did not decide to self-administer Dirigo Health. Instead, the state contracted with Harvard Pilgrim, a non-profit insurer.
In June 2007, the State Supreme Court upheld one of the major sources of financing for Dirigo Health—savings offset payments. Dirigo Health is funded, in part, by a controversial assessment on insurance companies called savings offset payments. The assessment is based on an estimate by the Dirigo Health Agency of the overall health system savings that result from the Dirigo Health Plan, which were $44 million in 2004. Insurers in Maine sued the state over the savings offset payments, and the Supreme Court voted 5-1 in favor of the state.
Lawmakers sought other funding options to support health reform, and in April 2008, they enacted a beverage tax. The tax amounted to about 4 cents on a can of soda, 7 cents on a bottle of wine, and 16 cents on a six-pack of beer. It would have raised $49.6 million to finance Dirigo Health. However, in November 2008, Maine voters approved a ballot initiative—sponsored heavily by beverage industry businesses—to repeal the tax. Regardless of the repeal, the state will continue to levy savings offset payments on health plans to fund Dirigo Health. Furthermore, after the November election, Governor Baldacci indicated an interest in applying for federal waiver to obtain federal matching dollars for DirigoChioce enrollees earning less than 300 percent of poverty ($52,800 for a family of three in 2008).
Maine Expansion Resources
For general resources on state expansions, see Other Resources.
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