December 23, 2024
Column

Why Maine needs Dirigo Health

Dirigo Health is Maine’s investment in making quality, affordable health care available to all Mainers. It is a part of my broader economic development strategy to help small businesses find and keep affordable health insurance for their workers.

Confronted with a difficult budget shortfall some have proposed a retreat from Dirigo Health arguing that state funds secured for Dirigo be used for other purposes. This might be pennywise but surely pound-foolish and would cripple Dirigo even before it begins.I will not retreat from my commitment to Maine’s small businesses and uninsured citizens. Dirigo Health is part of the solution to our economic hard times. By reducing costs, improving quality and covering more people with health insurance we all benefit. When we reduce the number of uninsured, we diminish the costs passed on to the rest of us as higher premiums.

Dirigo Health has already begun to work. Information is now available to help Mainers be smarter health care consumers; evidence shows a slowing in the rate of growth of some health insurance premiums; an advisory group is hard at work to craft a thoughtful plan to insure Maine’s health system delivers care effectively and efficiently to all citizens of our state now and in the future; a Commission to Study Maine’s Hospitals is already producing useful information; and the Maine Quality Forum is in place. This July, Dirigo Health will open enrollment in an affordable health plan to small businesses, the self-employed and individual citizens in Maine. The Dirigo Health Plan will be delivered by a private insurance company and will help employees and individuals pay premiums by providing discounts, based on ability to pay, to those whose incomes are below about $55,000 for a family of four and $27,000 for an individual. Those discounts will be funded by the $53 million some now seek to cut.

Last year Maine’s Legislature voted in a two-thirds majority to invest that $53 million in one-time state funds to launch Dirigo Health. This money is not a piggy bank to raid when times are tough; it’s an investment in Maine’s small businesses and families. In February we’ll ask insurance companies to send us bids to deliver the Dirigo Health plan. Those companies need to know we have the financing to support our plan. In July small businesses and citizens will be able to purchase the plan. They need to know we’ll be able to fund the discounts that will make Dirigo affordable to 31,000 Mainers who now lack health insurance and simply can’t afford the premiums.

And let me clear up some confusion. Our budget does not require the Legislature to choose between hospitals or Dirigo Health. Both are essential components of a vibrant and strong health system for Maine. If we work together, we can meet our promise to Maine citizens to launch Dirigo Health and sustain strong hospitals. Working with the Legislature, we have reached an important compromise regarding hospital financing that significantly reduces my original proposed cuts. We will extend a program already in place for nursing homes to include the state’s hospitals. In so doing we will be able to bring to Maine additional federal funds and reduce the cut to Maine’s hospitals.

Like other health care providers in Maine, hospitals will now share a proportional cut in revenues to help address the shortfall. This program, “tax & match,” is in place in many states including Maine, and allows us to assess hospitals less than 1 percent of their net operating revenues to generate federal funds, most of which are then redistributed to hospitals through MaineCare reimbursements.

We appreciate that tough times require tough decisions and creative solutions. But it’s tough times for Maine businesses and citizens, too, and we need to resist the temptation to turn to them. Our health care system is strong but so is it costly and sometimes it’s inefficient. We need to find ways of working together with hospitals and many others, to better plan and direct all our health care resources.

But most importantly, Maine businesses and uninsured citizens can’t wait any longer for help. Dirigo Health is our state’s promise to lead the way to assure our citizens more affordable health insurance and a more cost-efficient and high-quality health system for all of us. This investment in our people and our businesses simply must not be derailed.

John Baldacci is the governor of Maine.


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