Daniel Bernier made a very “risky” proposition in his commentary, “How to lower Maine’s high health insurance rates?” (BDN, 8/3/05).

Mr. Bernier, a lobbyist representing the Maine Independent Insurance Agents, would repeal guaranteed issue, create a high-risk pool and dramatically relax community-rating standards. This is wrong for Maine and wrong for small businesses. To see why, we only need to look at the states Mr. Bernier wants us to copy.

First, let’s talk about risk to see how Mr. Bernier’s proposals would affect you. If your insurance company considers you a risky client, one of two things would happen: (1) you would be denied health insurance when you apply for it; or, (2) your premiums would skyrocket because the insurance company could set your premium based on how risky they think you are to insure.

What does risky mean? You would be a risky client if you have had cancer, have diabetes or chronic asthma, suffer from a mental illness, had a debilitating accident, were a woman of child bearing age, or any other costly medical condition. Are Mr. Bernier’s proposals risks you’d be willing to take?

In 2002, New Hampshire eliminated guaranteed issue in the individual market, allowing insurance companies to refuse to sell you a policy if they think you are too risky a client. At the same time, they created a high-risk pool for those individuals denied private health insurance. Individuals don’t have coverage through an employer and must navigate the insurance system by themselves.

Though it was created in 2002, New Hampshire’s high-risk pool has only 500 people enrolled to date. Premiums range from 125 to 140 percent of the standard market rate and can be as high as $1,400 per month depending on the plan, your age, and other factors. Deductibles are up to $5,000 and total annual out of pocket costs can be as much as $10,000 for out-of-network services.

Coverage in the high-risk pool is not comprehensive. If you want coverage for maternity care, the maternity rider would cost you an additional $500 to $1,000 on top of the monthly premium.

The theory behind high-risk pools is that they remove the sickest from the insurance pool, thereby reducing premiums for everyone else. The fact is, however, high-risk pools are expensive to run, expensive to join and serve too few people to have a measurable impact on premiums. High-risk pools have to be subsidized by state governments using tax dollars. We end up paying either way.

In addition to making these changes in the individual market, New Hampshire relaxed its community rating standards for small businesses by, in part, allowing insurance companies to consider risk when setting premium prices. Community rating is a good way to keep premiums down for everyone across the board because everyone shares the risk instead of discriminating against people based on the likelihood of their requiring medical treatment.

New Hampshire small businesses were hit hard by the relaxed community-rating standards. Foster’s Daily Democrat, a leading newspaper in New Hampshire, reported that some small business premiums increased by as much as 200 percent. Small businesses with fewer than 10 employees were hit hardest.

Support for reversing these changes was strong and bipartisan. On July 5, with support from Democrats and Republicans, New Hampshire’s governor signed SB 125. This legislation made community rating stricter again by, in part, removing “risk” from the equation. New Hampshire small businesses hailed this change. In light of the lessons learned in New Hampshire, we should not put Maine’s small businesses and individuals through this roller coaster.

Throughout his commentary, Mr. Bernier compared Maine premium prices with those in other states, notably Kentucky. He suggests that premiums in Kentucky are dramatically cheaper than in Maine. However, he quoted only base prices available from the Internet. Your actual premium would go up based on your risk factors, like your health status or history.

Comparing premium rates from state to state provides provocative, but wholly misleading, conclusions. Comparisons like that need to answer two questions: (1) Is the coverage comparable? (In Mr. Bernier’s comparison the answer is “no”), and (2) Does health care actually cost the same in both states? Mr. Bernier’s proposals do nothing to address the underlying high costs of Maine’s health care system. Our premiums will still be high until we grapple with our high health care costs.

Kentucky is one of the unhealthiest states in the country, according to the Courier-Journal in Louisville. It has high rates of smoking, obesity, heart disease, diabetes and cancer. On July 17th, the Courier-Journal reported that “chronic poor health threatens lives and hits all Kentuckians in the pocketbook through taxes and insurance premiums.” Although we’re working hard to improve health care in Maine, we were recently ranked the 10th healthiest state. Clearly, Kentucky is not the state to emulate when it comes to healthcare.

Results in New Hampshire and Kentucky, where they have instituted the reforms that Mr. Bernier advocates, do not indicate that his free-market proposals will achieve the health outcomes we need. Maine should not look to other states for answers when we already have a ground-breaking plan under way to provide greater access while addressing cost and quality in the healthcare system.

Our Maine ingenuity brought us Dirigo Health, and Maine should continue to rely on our own good sense. After just eight months, DirigoChoice health insurance has enrolled 8,000 Maine people, including 2,000 businesses – helping them afford good quality coverage. Anthem says this enrollment rate is “significantly higher than other new health insurance programs.” (Remember, New Hampshire’s high-risk pool has just 500 people after three years!)

And Dirigo Health is more than health insurance. It is working to reduce health care costs that we all pay in our premiums and to improve health care quality. Gov. Baldacci and Democrats in the Legislature are right to continue supporting this landmark health reform.

We’re not in favor of letting the insurance industry lobby put Maine’s health at risk. Let’s learn from the mistakes of other states, and follow our own plan to become the healthiest state in the nation.

David and Gloria Coomer of Brooksville own Solarmarine Electric and are members of Maine People’s Alliance.