Members of Maine’s Blue Ribbon Commission on Dirigo Health, created by Governor John Baldacci to evaluate components of the state subsidized coverage program for the uninsured, are reviewing Dirigo’s funding mechanism in an effort to control program costs while ensuring quality for “hard working Mainers.” The Dirigo Health Reform Act, and the subsidized insurance product DirigoChoice, have provided more than 10,000 individuals and small businesses in the state with access to affordable health insurance and have generated $43.7 million in savings in the first year of operation. However, under current law, the program is partially funded through “savings offset payments” from health insurers in the state—payments some critics complain amount to an illegal tax. Although the savings offset payments are designed to recapture savings to the health system from the Dirigo program, insurance companies and Dirigo officials disagree over how much savings this program has generated and whether offset payments are the best way to finance the program.
This disagreement prompted three groups to sue the state in Superior Court on three counts. They claimed that: the law creating Dirigo was unconstitutional; that assessing insurance companies to recover savings was illegal; and that a program savings of $43.7 million was not justifiable. In the end, Superior Court Justice Ronald Cole ruled in favor of Dirigo Health on all three contentious issues. Although this is a victory for Dirigo and its financing mechanism, the Governor’s Blue Ribbon Commission will still perform a comprehensive analysis on all program components.
Officially, the 15-member Commission, which includes representatives from the legislature, insurers, providers, and taxpayers, has been charged to make “recommendations with respect to long term funding and cost containment methods” to further the mission of Dirigo Health and ensure that health care continues to be accessible and affordable for the people of Maine. Various funding alternatives will be considered, including the offset payments strategy. Since the Commission is not expected to submit their recommendations until mid-December, the continued funding of Dirigo Health remains ambiguous.
For more information on the specifics of DirigoChoice and the Dirigo Health Reform Act, visit SCI’s Profiles in Coverage at http://www.statecoverage.net/profiles.htm.
