Maine requires community rating ( all the insured pay the same premium for the same insurance coverage under each policy choice ) and no discimination due to pre existing conditions. This has driven insurance companies out of the Maine market and increased premiums by those few insurer's willing to cover Maine citizens.In an attempt to improve the situation the legislature enacted Dirigo Choice which was designed to provide access and subsidies, particularly for small business, the self employed and individuals without any coverage. Due to the instability of the funding mechanism the program has been closed for two years to new subscribers. It is currently managed by Harvard-Pilgrim (a non-profit). The rising costs of medical care have driven up the monthly premiums and increased the amounts to be paid out of pocket.
As members drop out due to age, attrition, inability to pay premiums or return to covered employment, the number of covered members is declining. For those without other healthcare insurance options Dirigo has been a lifesaver. In the early days of Dirigo Health many potential members were not able to pay the full upfront premium and then wait to be reimbursed for their subsidy amount later. That system has since been corrected.
As we look at expanding health insurance coverage to more Americans much can be learned by looking at the states that have tried to do just that.
We know that Senators Collins and Snowe will give thoughtful consideration to the plans being formulated in Washington and will throw a life ring to those who need the help of a public option.
Harvard Pilgrim Dirigo Health - Maine People's Alliance
