As I travel our state I hear stories from families and small businesses - working hard to grow and prosper. These are your neighbors and friends - the business owner who struggles with the decision of whether she can provide health insurance for her employees; the mom who’s scared to death to let her children participate in sports, knowing a broken arm could break the family budget. It is time to take steps now to expand Dirigo and to ensure all Maine people will have the security of health coverage.
|Governor John Baldacci of Maine|
Maine people need and deserve affordable, quality health care that we can depend upon. That’s why on my first day in office I started the hard work to create the Dirigo Health Reform. I asked all the interested parties – including many vocal opponents – to come together to help us craft a plan for Maine. I said then that the road was long, the work was hard, but that it was work that had to be done.
Health reform is a national imperative. With health care costs growing 2 to 3 times faster than the cost of living, in Maine we did not wait for Washington. We realized we can do better. With Dirigo, we are doing better. Maine is leading the way.
Dirigo is working. Now is not the time to turn back, but to move forward and to recognize this difficult task is one that must be undertaken together.
Dirigo saves money and controls costs, and this helps every Maine citizen. In fact, $43.7 million of savings has been achieved in the Maine health care system, and 15,000 people have had coverage thanks to Dirigo. Maine is one of only seven states in the nation that has seen a decrease in the number of uninsured. We are getting healthier. We have received national attention for reducing the rate of smoking, and our health ranking improved from 10th to 8th in just one year.
DirigoChoice, the subsidized insurance product offered through Anthem, is an essential element that is working for Maine people. We gained valuable experience from the first year of DirigoChoice. We need to continue our work with providers to make our health care system even more efficient, to find savings and to return those savings to hard working Maine families and businesses.
My proposal would give the Dirigo Health Board the authority to self-insure, like many large businesses in Maine. That means we can take out the profit making middleman and use those dollars to pay for more coverage and improved marketing. The option to self-insure would allow us to move quickly to develop new, innovative and more affordable benefits.
Self-insured (also known as self-administered) is the most common mechanism used by health insurance sponsors for medium and large groups. Dirigo Choice has grown and is ready to take its place with many Maine employers who self-insure like LL Bean, Maine State Employees Association, Cianbro and Maine Bankers Association. Nationally 82% of firms with 5,000 or more workers have plans that were partially or fully self-insured.
Establishing a self-administered plan is the next logical, incremental step in the evolution of Dirigo Health. Moving to a self-insured product will ensure continuity of coverage for all members. The public/private relationship will continue to exist, because Dirigo, like most self-insured companies, will contract with a third-party administrator for the processing and appeals of claims.
If the Legislature enacts this proposal, we will have the necessary options available to guarantee the best product at the best price and effectively reach even more people.
As the administration of the program will be contracted out to a third-party administrator, it will not create a new government bureaucracy. It will, however, enhance the ability for Dirigo to provide coverage at a more affordable price. The State will not be liable if Dirigo is self-administered. The program will purchase re-insurance to protect it against large, unanticipated claims. The program will be self-sustaining. The Maine State Employees Health Insurance Plan recently successfully used this mechanism to lower its costs.
My message to every Maine citizen, to every business, is that we are serious and committed about health reform. I will work with all the stakeholders to ensure that we meet our goals because this is the right thing to do.
Some propose to separate the wealthy and healthy from the poor and the sick. I will have none of that. We are in this together. It’s not good enough for some of us to be healthy, for some of us to have health insurance. Dirigo Health reform is about all of us – working for the day when no one in Maine worries about paying a premium or paying the heating bill; where every business knows it can provide its workers good coverage at a fair price.