Gov. John Baldacci’s health reform plan has three major goals: to broaden access to health care, hold down rising costs and ensure the quality of health care in the state. The specific proposals include:
. Create Dirigo Health to provide affordable health coverage through private carriers in small businesses and among the self-employed and their dependents.
. Expand MaineCare eligibility. Expansion would not require federal waivers. Workers ineligible for MaineCare would get assistance, based on ability to pay, for Dirigo Health coverage.
. Provide health care assistance for up to 300 percent of poverty standard by pooling contributions from individuals, employers, state and federal governments.
. Create a state health plan to match capital investments with public health goals.
. Place a one-year moratorium on certificate-of-need requests for nonemergency medical expansions while state health plan is developed.
. Work with hospital and physicians’ groups to assess primary and acute needs and develop a plan to address them, and strengthen rural health care.
. Require disclosure of average charges for commonly performed services at hospitals, doctors’ offices and health centers to help consumers make more informed choices.
. Require the use of standardized billing forms and codes to reduce paperwork.
. Order public entities to coordinate purchases of health services to save costs.
. Require reviews of requests for rate increases in the small group market. Add new requirements for rate requests in the large small group market.
. Reduce “cost shifting” by charging upfront fees on health premiums to provide coverage to more uninsured people. Insurers no longer would have to pass costs of charity care and bad debts to payers.
. Ask providers to hold price increases, and insurers to limit underwriting gains, to 3 percent through 2004.
. Create watchdog group to promote best practices and monitor health care performance.
. Encourage better use of data for health planning, improvement of services and public review.
. Pass a constitutional amendment to make sure all tobacco settlement money is used for health care.
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