Maine's plan to cover all who are uninsured advances

[NRSKarenRN, BSN, RN]

Posted on Fri, Jun. 13, 2003 Phila. Inquirer

Maine's plan to cover all who are uninsured advances

Those who could not afford coverage would be able to get it by 2009. The bill won a preliminary OK.

By Glenn Adams

Associated Press

http://www.philly.com/mld/inquirer/living/health/6076389.htm

AUGUSTA, Maine - State lawmakers moved closer yesterday to enacting one of the nation's most far-reaching health insurance plans, burnishing the state's reputation as a pioneer in expanding access to medical care.

The House and the Senate gave the bill preliminary approval. Final approval could come by today, and first-year Democratic Gov. John E. Baldacci has endorsed the plan, which would create a quasi-public agency to help people secure medical coverage through private insurers.

Under the Dirigo Health plan, all 180,000 people in Maine who cannot otherwise afford coverage would have access to it by 2009. Dirigo, the state motto, is Latin for "I lead."

Participants would be charged subsidized premiums that would vary according to their ability to pay and the amount of coverage purchased.

The program would not require a general tax increase. Funding would come from a patchwork of sources, including a tax on insurance companies, federal funds, and $80 million the state expects to save each year by eliminating unreimbursed medical costs run up by uninsured people.

Maine also has a program called Maine Rx, in which the state uses its buying power to force drug companies to offer bulk discounts on prescription drugs for the elderly, the working poor, and others who have trouble paying for their medicine. Maine Rx was upheld by the U.S. Supreme Court last month.

"This is the only state in the country that has a clear plan, funded to provide universal health care in five years," State Sen. Michael Brennan said.

Maine's move toward universal coverage is unusual in a year when most states are simply trying to hold on to the coverage they have, said Donna Folkemer of the National Conference of State Legislatures.

The Maine plan builds on and combines efforts under way in states such as California, Minnesota, Vermont and Rhode Island, Folkemer said.

The legislation aims to hold down the costs of medical care with voluntary price caps for providers, hospitals and insurers, and a limit on nonhospital outpatient procedures.

"It means that everybody in the world won't be getting an MRI," said Brennan, a Democrat who helped lead a month of tense talks among disparate interests.

Self-employed workers and owners of small businesses could obtain coverage through Dirigo.

While hospitals, insurers, doctors, businesses and patient advocates have endorsed the plan, doubts linger among some.

"There's real cost containment and real reforms, but it would be a disservice to say premiums will go down and access to health care will be free or cheap," said Steve Michaud, president of the Maine Hospital Association.

[Katnip, RN]

I wonder if this includes limitations on ED visits for things like toothaches and sniffles?

[sbic56, BSN, RN]

I sincerely hope Dirigo Health helps Mainers. It is a bold initiative, but we need to do something. The healthcare coverage here is pathetic. Something has to be done soon!