Just how good is Dirigo Health?

Pat Colwell’s Nov. 29 op-ed regarding Dirigo Health was heavy on rhetoric and short on facts. After maligning the integrity and nonprofit, nonpartisan status of the Maine Heritage Policy Center, he does little to respond to the sobering facts of the faltering status of Dirigo Health.

When introducing the Dirigo Health legislation in June 2003, Gov. Baldacci promised that it would eliminate all 135,000 uninsured Mainers within five years, require no new taxes and reduce health insurance premiums. Dirigo Health’s actual performance is much less lofty. As highlighted in recent Maine Heritage Policy Center presentations and papers, here are the facts about Dirigo Health:

. Fourteen percent of DirigoChoice enrollees drop out within 10 months. In November, the Baldacci administration admitted it had been neglecting to report the number of people who had dropped coverage. Since it began in January, 8,500 people have enrolled in DirigoChoice. However, 1,200 of that 8,500 had discontinued coverage by November, leaving just 7,300 people still with DirigoChoice coverage. In the aggregate, this means that one in seven people (14 percent) signing up for DirigoChoice dropped the plan after being covered less than 10 months.

. Low numbers of uninsured were reached. In August, the Muskie School of Public Service at the University of Southern Maine released the results of a survey of DirigoChoice enrollees revealing that just 22.4 percent of those with DirigoChoice were uninsured at the time they purchased DirigoChoice. This means DirigoChoice has provided coverage to just 1,635 uninsured in 10 months.

. DirigoChoice is very costly to Maine taxpayers. The Dirigo Health Agency finally released to the Maine Legislature an accounting of funds spent through Sept. 30. For the first nine months of 2005, the agency had a net cost to taxpayers of $19.5 million. DirigoChoice costs Maine taxpayers a net $414 per member per month or almost $5,000 per member per year. These costs include all premium payments, Dirigo Health administrative costs, subsidies paid to individuals, after deducting contributions received by participating small business employers and employees.

. DirigoChoice costs Maine taxpayers almost $16,000 a year for each uninsured person covered. Given that only 1,635 uninsured individuals were covered by DirigoChoice in the first nine months of 2005, the estimated annual cost to Maine taxpayers for each uninsured person covered by DirigoChoice is more than $15,900 per uninsured person per year. State taxpayers fund almost all of these costs with few federal matching dollars (except for about 2 percent of enrollees who are Medicaid eligible).

. New Dirigo tax to add 2.4 percent tax on health claims. On Nov. 22, the Dirigo Health board of directors approved a new Dirigo tax of 2.408 percent tax on all health insurance claims paid within Maine. All individuals and companies, regardless of size, including those self-insured large companies, must pay this tax projected to raise almost $44 million in 2006 alone. For those with single coverage this tax equals about $75 per year and about $200 per year for those with family coverage. This tax is in addition to the 2 percent health insurance premium tax paid on all non-HMO insurance plans in Maine. The Dirigo tax is also likely in addition to the 15 to 20 percent 2006 premium increases pending for all small group and individual insurance plans in Maine.

. Dirigo’s Medicaid expansion moves forward despite Maine now having the largest Medicaid program in the nation. In May, the Medicaid expansion part of Dirigo Health began providing Medicaid coverage to parents earning between 150 to 200 percent of poverty. According to the Kaiser Family Foundation, Maine now has the largest Medicaid program in the country as a percent of all individuals under 65 years old on Medicaid.

. Gov. Baldacci’s approval rating is dropping. As he heads toward re-election in November 2006, Gov. Baldacci faces a doubtful public with 45 percent of those surveyed saying the governor did not deserve re-election compared to just 38 percent supporting another four-year term approval rating, according to a fall 2005 tracking poll by Critical Insights of Portland.

Pat Colwell and Maine Democrats are correct. Maine people are looking to Augusta for real health reform. Dirigo Health is a failure, costly and not meeting its goals. The Maine Legislature should cut its losses and pass real health reform replicating successful efforts occurring in other states around the country.

Tarren Bragdon is the director of Health Reform Initiatives of the Maine Heritage Policy Center. He authors the DirigoWatch report available at www.MainePolicy.org and can be reached at tbragdon@MainePolicy.org.