Maine provides another lesson - for failure
Report of the Blue Ribbon Commission On Dirigo Health (Maine)
January 2007
From the Final Recommendations:
The Commission expresses its unanimous support for the Dirigo Health Program and its goals…
- Regarding making health care coverage more affordable overall, the Commission endorsed the following initiatives:
- increase transparency of insurance rates by building publicly available data sets that allow consumers and employers to review health plan offerings against broad set of comparative metrics.
- allow sole proprietors to purchase coverage in the small group market
- create options to allow non-subsidized individuals and employees to purchase health care coverage using pre-tax dollars
- Regarding individual market reform, the Commission recommends that the Governor appoint a work group representing the Bureau of Insurance, GOHPF, consumers, insurers, providers and employers to begin immediately to conduct an analysis of three options — (1) high risk pools, (2) merger of the individual and small group markets, and (3) reinsurance options applied to the individual market or merged market option — as well as combinations of and different versions of these options, and that the results of that study guide policy makers in proposing specific solutions to the individual health insurance market in 2007.
- Regarding employer and individual mandates, the Commission endorses the concept of an employer mandate along with a mandate for individuals with income over 400% FPL, and recommends that the Governor move forward to explore the parameters of how such mandates would work, including, but not limited to such issues as: what is considered credible coverage; what would be a reasonable payment for businesses who elect not to purchase coverage; and how the individual mandate would be enforced.
http://dirigohealth.maine.gov/BRC%20Final%20Report.pdf
Comment:
Don McCanne, MD
When the Maine legislature passed the Dirigo Health bill in June, 2003, it was hailed as a bill that promised “affordable coverage to all Mainers.” A Quote of the Day message at that time stated that the policies developed sacrificed “the goal of an affordable, comprehensive and truly universal system.”
http://www.pnhp.org/news/2003/june/maine_succeeds_in_ad.php
Since the Dirigo Health program was not working, Governor Baldacci issued an Executive Order establishing The Blue Ribbon Commission on Dirigo Health. They have now released their final report.
We have covered many times the reasons why state efforts to achieve universal coverage through individual and employer mandates to purchase private health plans cannot ever achieve the goal of reasonably comprehensive coverage for everyone. I do not need to restate those reasons to come to the conclusion that the recommendations of the Blue Ribbon Commission “cannot ever achieve the goal of reasonably comprehensive coverage for everyone.” (Is there an echo in here?)
My message on June 14, 2003 to health care reform activists in Maine remains the same today:
“Those of you in Maine who are continuing to craft the single payer model, please do not leave your tables. Maine desperately needs your program, as will soon be evident.” (as if it weren’t already)