Health reform panel seeks more details

AUGUSTA – Members of the Joint Select Committee on Health Care Reform asked the architect of Gov. John Baldacci’s Dirigo health bill for more detailed information about the universal insurance plan as legislative hearings moved into their second day.

Trish Riley, head of the governor’s Office of Health Care Policy and Finance, was joined before the committee by representatives from the Edmund S. Muskie School of Public Service in Portland and Mathematica Policy Research in Washington D.C. Both organizations have helped to develop the reform plan.

Riley presented a legal opinion by consultant Andy Schneider of Medicaid Policy LLC in Washington D.C., stating that the plan’s innovative use of Medicaid funds is allowable under federal law. The plan also has been examined by Maine’s Attorney General, Steven Rowe.

Her presentation identified the total number of Maine residents eligible for subsidized enrollment in the proposed individual and small-group insurance plan – about 189,000.

She included a range of financial breakdowns based on how many people enroll in the plan, and she explained the financial contributions of employers, employees, federal Medicaid funds and Maine’s insurance providers.

Still, committee members requested Riley to come up with yet more information, including:

. Comparative reimbursements to hospitals and other medical providers by Medicare, Medicaid, Worker’s Compensation and insurance companies;

. A breakdown of the benefit package envisioned for the Dirigo plan compared to the state employees’ plan;

. The impact of a proposed 4.1 percent surcharge on the premium revenues of insurance companies.

Sen. Karl Turner, R-Cumberland, asked Riley to obtain federal approval. Turner speculated that the federal government might someday cut Medicaid funding to states or close the “loophole” that allows the Dirigo plan.

“The worst thing we could do is build an expectation around a funding source that is uncertain,” he said.

Riley said she would “do whatever the committee wants,” but seeking federal approval would be “asking the federal government to approve what is already the law of the land.”

Rep. Thomas Kane, D-Saco, said such a request would delay the passage of the bill and might also “raise a red flag” at the federal level.

“I sure don’t have any need to invite the scrutiny of the federal government at this point,” Kane said.

The issue of obtaining federal approval will be revisited at a later date, said committee co-chair Sen. Michael Brennan, D-Portland.

Brennan said the process of refining the Dirigo bill will continue for as long as it takes to satisfy the committee that the interests of the many players in the Maine health care community have been adequately considered. Work sessions will meet at least through next week, he said.