County forum explores DirigoChoice’s future

PRESQUE ISLE – While the issues surrounding the Dirigo Health Plan are far from resolved, health care officials are hoping a series of business forums on the matter will help to generate new ideas and identify a mutually agreeable future direction for the insurance plan.

About 75 people attended the first forum, “Healthy Policy in Maine – Three Years into Dirigo Health,” on Thursday at the University of Maine at Presque Isle. The forum, one of four that will be held in Maine in the coming weeks, was co-sponsored by Eastern Maine Healthcare Systems and the Presque Isle Area Chamber of Commerce. Forums also will be held in Bangor, Pittsfield and Waterville.

“This is about how employers, providers, the community and policy folks in the state see the future [of Dirigo Health] and how to create the best possible collaboration for the people of Maine,” said M. Michelle Hood, CEO of Eastern Maine Healthcare Systems.

The Dirigo Health Reform Act has been under debate since it was voted into law in 2003 to provide coverage for 130,000 uninsured and underinsured Mainers. One of the most controversial provisions of the law is DirigoChoice, a health insurance plan which has about 10,000 members and includes premiums with a sliding scale subsidy and deductibles based on income.

State officials say it has created a cost savings of about $43.7 million, which under the Dirigo law, is supposed to be paid back into the system by insurers in the form of a saving offset payment, or SOP. Insurers call the SOP a tax or a double dip and say the cost will have to be added on to policyholder premiums.

While state officials say they are refining the plan, two bills – one that would have given the Dirigo Health Agency more flexibility in contracting with outside insurance companies and another that would have prohibited insurers from passing SOP costs on to policyholders – failed this week in votes before the Maine State Legislature.

Bearing all of this in mind, speakers at the Presque Isle business forum disagreed on some points, but concurred that Mainers need to determine the plan’s future.

Adam Thompson, legislative liaison with the Governor’s Office of Health Policy and Finance, told the gathering Thursday that Mainers should “stay the course.” He pointed out that Aroostook County has 567 DirigoChoice members and includes 100 businesses.

“We all know you can’t fix things overnight,” he said. But pointing to the 9,790 members and 2,288 businesses that use the insurance plan, he called the enrollments successes that the state should build upon. “We should not scrap it,” he said.

Dan Coffey, executive vice president of EMHS, said Thursday that from the provider’s perspective, officials support the need for a reformed health policy in Maine but that the SOP is not a viable answer. He said that while the payment was intended to reflect the money saved from bad debt and charity care in the health care industry, that hospitals – at least in EMHS – have not seen a significant decrease in those costs.

Kristine Ossenfort, a government affairs specialist with the Maine State Chamber of Commerce, echoed those sentiments Thursday. She said, however, that the Chamber still supports Dirigo’s goals. She said a new funding mechanism must be identified in order to protect the viability of the program.

Dave Peterson, CEO of The Aroostook Medical Center, said that no matter how community members feel about the issue, officials hope something positive will come from the forum.

“Ultimately, we hope to have a common voice and point of view on what should be happening with the delivery and payment of health care services in Maine,” Peterson said.