The next step forward for Dirigo Health

zHC1.jpg (67810 bytes)

Governor Baldacci talks about Dirigo Health surrounded by healthcare workers at the celebration of the new state heathcare partnerships at the Capitol in Augusta, Maine

By Ramona du Houx

According to the U.S. Census Bureau for 2005-2006, Maine tied with four other states as having the lowest rate of uninsured in the country. Despite an increase in the rate of uninsured nationally, 15.8 percent, Maine’s rate of uninsured held steady at 9.5 percent.

"I am pleased that we have positive results to show for our efforts," said Governor Baldacci. "Momentum is growing in this country for a new direction on health care. We cannot be satisfied with a status quo that allows 45 million U.S. citizens to go without health insurance. It’s bad economic policy. But more than that, it’s just wrong for the most innovative, industrious country in the world to be content with such healthcare insecurity. The challenge of providing access to quality health care to all our citizens is a national problem that begs for a national solution. Until we have one, we will continue our efforts here in Maine."

Those efforts with the Baldacci administration started with Dirigo Health, which has a goal of making Maine the healthiest state in the Nation. DirigoChoice is the program’s insurance arm.

As of July 2007, more than 27,000 people have been covered by DirigoChoice and Dirigo's MaineCare parent expansion.

Harvard Pilgrim Health Care has been selected to administer Maine’s subsidized DirigoChoice health insurance program, taking over from Anthem Blue Cross next January. Harvard Pilgrim is unique in the insurance market; it’s the only nonprofit insurance company in America.

"We’re excited. This partnership is the next step in moving Dirigo forward. As well as being great for DirigoChoice subscribers, it means we will have competition in the healthcare insurance market," said the governor. "When you have only one healthcare provider, then they basically can do anything they like. They are in control. With two providers, or more, they have to compete, which means we will have better prices for consumers."

Robert Downs of HarvardTrish Riley, director of the Governor’s Office of Health Policy and FinancePilgrim said he intends to widen access to health care in Maine. "We have a similar mission to Dirigo, as a nonprofit. This is a great partnership for us to build our business, and the people of Maine to have more access to health care," he said.

Harvard Pilgrim was ranked as the number-one healthcare plan in America in 2006, according to a joint ranking by U.S. News & World Report and the National Committee for Quality Assurance.

"The best news is that this partnership, with a highly reputable agent and months to prepare before the end of Anthem’s contract, will ensure that no policyholders experience a lapse in coverage during the transition," said House Majority Leader Hannah Pingree.

Trish Riley, director of the Governor’s Office of Health Policy and Finance,(photo above) said that Mainers should expect only a few minor changes in DirigoChoice under Harvard Pilgrim. "This company is mission driven and shares our concern for the uninsured. I look forward to a smooth transition for our 15,000 DirigoChoice members," said Riley.

The policy deductibles, covered services and subsidies for the coming year are likely to be similar to current provisions. Monthly premiums may increase, as they are with other insurance providers, but by a smaller percentage because of Harvard Pilgrim’s nonprofit status.

Harvard Pilgrim currently covers about 50,000 Mainers. The company writes policies for individuals as well as for employees of small and mid-sized businesses, including Franklin Memorial Hospital and Oakhurst Dairy.

Recently Maine’s Superintendent of Insurance determined that Dirigo Health saved almost $33 million in healthcare spending last year, proving for the third year that the reform act is significantly saving money. Those savings will be reinvested in expanding coverage to people who don’t have heath care.

In addition to having more insurance carriers for competition, the governor said we need to adopt market reforms that will make the rates more transparent while holding down costs.

"If we work together, put aside the partisan bickering and focus on good public policy, Maine can continue to be a leader in making sure people have quality affordable health care. We can continue to be a model for the rest of the country," said Baldacci.