September 21, 2024
Column

Dirigo is Maine’s wrong choice

I am astounded that anyone could possibly describe Dirigo Health as a success. Established as a program to make health insurance more affordable for large numbers of uninsured, resulting in lower health costs for all Maine residents.

It has accomplished none of these goals:

Premium rates for DirigoChoice as costly (in part because Dirigo will provide full coverage for anyone who has not previously been insured, irrespective of their medical history.)

Large numbers of the uninsured have been enrolled. Of the currently 7,300 individuals in the plan nearly one-third had prior health insurance coverage. The remainder of Gov. Baldacci’s stated 21,000 enrolled have merely been added to our already strained MaineCare population.

The “savings” attributed to Dirigo Health will be paid by Maine residents in the form of an assessment included in their insurance premiums.

The number of uninsured residents in Maine should indeed be of concern – though we actually have a lower percentage of uninsured that most other states in New England. This “problem” exists in part because of the large number of people who either don’t believe that they expect to need health care services or know that they can simply show up at an emergency room and be treated with little or no responsibility for the cost of their care. Much of the money spent to create and advertise DirigoChoice could have been better utilized as direct subsidy to low income Maine residents for the purchase of existing health insurance coverage.

Also, I have always understood the term savings to mean money that has not been spent. Therefore, the assertion that Anthem should be able to simply absorb the 2.4 percent assessment without including it in their rates in unrealistic – especially since only a small portion of the calculated savings is attributed to reduced provider charges.

As sensible and practical New Englanders we need to find a better way to provide for the health care needs of our citizens. A start would be to revise our regulations to encourage other insurance companies to once again sell their products in our state and create competition in the marketplace. And, rather than trying to invent a new system, we should look at other states with similar demographics to learn why they have significantly lower premium costs for health insurance, then adopt those strategies here.

Maureen Hedges is a certified employee benefit specialist and the Maine state chair of the Association of Health Insurance Agents.


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