Let’s take control of Dirigo

As a small-business owner and entrepreneur, I am writing to urge the Maine legislature to pass LD 431 – An Act to Enable the Dirigo Health Program to be Self-Administered, sponsored by Rep. Jill Conover of Oakland. I appeared in November at the Bureau of Insurance public hearing in Gardiner regarding the outrageous rate increase Anthem was then requesting for the Dirigo product. I left that hearing mystified by Anthem’s reluctance to answer questions. I am convinced from what I heard and saw that Anthem is no friend to the Dirigo plan or its subscribers.

DirigoChoice is thriving as a viable, affordable health insurance plan for Mainers. Before I quit a full-time job in Maine to start my own business, I carefully investigated health insurance options for my husband and me. Policies available to us as nongroup subscribers were exorbitant; premiums for policies approximating the coverage offered by my then-employer were well over $1,000 a month. Group policies available by joining one or other professional association carried lower premiums, but such policies essentially covered only catastrophic care. Although both my husband and I are in reasonably good health, neither of us is a “spring chicken,” and going without health insurance is not an option for us. Neither is reducing our coverage to one of Anthem’s so-called high-deductible, catastrophic plans. The only solution was coverage through COBRA.

Our COBRA period was about to expire when the DirigoChoice program opened enrollment, and we became subscribers in January 2005, Dirigo’s first month. To keep my publishing-consulting and editing business here in Maine, I need access for my husband and me to affordable health care, which also means access to affordable health insurance. My husband and I own our home in Camden, and we intentionally do most of our business with local, Maine companies.

We think we contribute as much to the state’s economy as our household income can bear. Are we the kind of people Anthem wants to drive from the state because health insurance, and health care, is no longer affordable? This is a company that posted profits of $41 million in 2005, just before they demanded double-digit rate increases.

Dirigo Health premiums will become unaffordable if its competitor in the market, Anthem, is allowed to continue to administer the state’s product. After posting a $3.6 million profit off of the DirigoChoice product alone, Anthem had the audacity to ask for a rate hike of 23 percent. Allowing Dirigo to self-administer means that money could be put back into the Dirigo Health system, to lower premiums for subscribers and to expand Dirigo so it can cover more Mainers.

Maine People’s Alliance and Consumers for Affordable Health Care are two nonprofit entities that have done what to my mind is a real public service by championing the plan in public hearing after hearing, doing their own research as a necessary counterpoint to information released by Anthem, and keeping consumers informed about the facts regarding Dirigo.

In fact, it was through MPA – not Anthem – that I first learned that enrollment for DirigoChoice was about to open back in the fall of 2004. And CAHC legally intervened, on behalf of consumers, to fight Anthem’s exorbitant rate requests, and is still fighting in the Maine Law Court for the savings offset payment to be honored, as agreed, so Dirigo can continue to function.

Over the years I have subscribed to many different health plans, either as a corporate employee, a state employee, or a self-employed, nongroup individual. The plans have run the gamut from HMOs to POS plans to government-sponsored plans. Before Dirigo Health, however, I had never encountered a health insurance plan that was administered by a competitor.

I implore all legislators to do your utmost to see that the Dirigo Health fulfills its mission to provide viable and affordable health care insurance to Mainers like me, and right now that means supporting LD 431. Let’s take control of the program, get rid of the profit motive, lower premiums, and cover more people.

Deborah Oliver is a DirigoChoice subscriber and advocate. She is the owner of Ab Initio (“From the Beginning” Publishing Consulting and Editing) in Camden.