New England accounts for six of the top 12 healthiest states in the latest annual report from the United Health Foundation, so it isn’t so surprising that Maine ranks eighth, up two places from last year. The public investment for this positive ranking and several other indicators, however, are worth a look, especially by lawmakers who may have health-care reform in mind this winter.

First and briefly, what the rankings are not. They are not evidence to “show that Dirigo Health is working,” despite that claim by the Maine Democratic Party. The fact that Maine has kept its rate of uninsured residents down is due to Medicaid, which also makes the Democrats’ opponents scream, but was around and growing long before Dirigo, the governor’s health reform. The percentage of nonelderly Mainers in 2003-’04 covered by Medicaid, called MaineCare here, was 21 percent compared with a national average of 13 percent. The state figure is the highest in the nation.

Maine has some of the highest health insurance premiums around, but its per-capita cost for MaineCare for 2005 – $158 – ranks it 21st among states and below the average national cost despite the fact that this state insures a much higher percentage of its residents through the public program. Doctors may rightfully complain about low reimbursement rates, but one of the things the United Health Foundation shows is that MaineCare delivers a lot of care inexpensively and at a considerably lower rate than most states.

A related statistic in the foundation’s index is the percentage of people without coverage.

Maine ranks fourth best in the country, with about 10 percent of its population lacking coverage. It’s worth noting that in 1990, when it had a slightly lower percentage without coverage, Maine’s ranking was considerably worse, 15th. Maine is moving up because other states are falling behind. But Maine’s rising Medicaid rate does not come from people dropping private coverage. Its percent of private coverage has stayed approximately the same as Medicaid has grown while its percent of uninsured remains substantially lower than the national average.

Finally, a statistic that suggests more improvements in the future: the percent of children under age 18 living in poverty has fallen from 33 percent in 1990, when Maine ranked 33rd, to 14 percent this year, ranking it 20th. Incomes in Maine have grown slowly against national averages for several years and remain below average, making the low poverty figure even more remarkable. Reducing the number of children in poverty may be the best way to raise incomes closer to the national, if not regional, average.

The overall message from United Health Foundation’s report is that while Maine has some problems – high rates of cancer, rising obesity – it is also doing a lot right. It is providing broad health-care coverage even as rising costs place ever more pressure on state systems to abandon their uninsured residents.