When legislators of both parties enthusiastically approved Dirigo Health two years ago, no one following the issue had any doubt that the ambitious undertaking of making sense out of health care coverage in Maine would need revision and reworking as it grew. Nearly every attempt to do that, how-ever, has been met with accusations the program is failing and that it be killed. It’s clear opponents fear that Dirigo, given a chance, will succeed and want to stop it before it does.

The latest argument, over Dirigo’s long-term funding source, has been present since the program’s inception but is apparent now because now is the time to put money on the table. Dirigo works by creating efficiencies in health care and reducing the rate at which insurance costs rise. A part of that reduction – known as the savings offset – is supposed to help subsidize Dirigo’s coverage and support the program’s quality-improvement work. That was acceptable to insurance companies but not to self-insured businesses, which, through the state Chamber of Commerce, has been negotiating with the Baldacci administration off and on over the issue.

LD 1577, before legislators this week, delays the start of the collection of this funding and changes the measure by which it is collected. Rather than limiting the offset to no more than 4 percent of premiums it would be measured instead against paid claims, not to exceed savings as a result of reduced bad debt and charity care.

Deciding how much has been saved in a system with so many moving parts is difficult, so the administration has had the accounting and consulting firm Mercer reviewing each component covered by Dirigo. That information will be presented to the Dirigo board and business leaders this summer, with the expected outcome of a total savings number by September. This is grinding, uninteresting but necessary work of the sort that gets ignored when politicians and lobbyists shout about killing Dirigo, but it will give a fair calculation of whether Dirigo, still very young, is having a measurable effect.

After the working group agrees on a number, it would be advanced to the superintendent of insurance for a public hearing – expect more shouting – then, if accepted, be made part of Dirigo’s funding. This is perhaps the most open way imaginable of figuring out a health care system, and it follows the advice of the Henry Aaron of the Brookings Institution and Stuart M. Butler of the Heritage Foundation, who argued last year in the journal Health Affairs that “federally supported state experimentation is a promising way to make progress” on reducing the number of Americans without health insurance.

Among the ways to experiment, the two suggest, is to create state programs that raise income limits under Medicaid or lower age eligibility under Medicare as well as “mandating employer or individual coverage, or creating a single state insurance plan through which everyone may buy subsidized coverage.” This kind of experimentation is exactly what Maine is doing, well within the thinking of conservative organizations that cannot avoid recognizing both the current health-coverage situation and the tip-toe steps of health-savings accounts as inadequate to repair the broken coverage system.

Over time, with modifications driven by experience, Dirigo could slow the rise of health care costs in Maine while covering more people and improving quality. But it can’t do those things while constantly defending itself against legislative attack. Whatever the program’s current shortcomings, the alternatives are worse.