Dirigo Health Care Act was a model for the Affordable Health Care Act


January 5, 2014

As of January 1, 2014, the Affordable Care Act (ACA) has been insuring over 2 million Americans. But over 70,000 Mainers, including 3,000 veterans in Maine, have been denied health insurance because Governor Paul LePage refused to accept federal funding for MaineCare from the ACA.

At no cost to Maine taxpayers, the state could have accepted the federal government’s offer to expand MaineCare health insurance for these people. Under the deal, with the first three years of the ACA the federal government would pay 100 percent of the costs of the MaineCare expansion. That’s three years. Then the state would have to pitch in, at the most just 10 percent of the cost. By anybody’s book that’s a good deal. With healthier workers, productivity increases and so do people’s outlook.

Most importantly lives would be saved, and businesses would grow.

Accepting federal funds would create and save 4,100 jobs in Maine, according to the Maine Center on Economic Policy.

Analyses by the Kaiser Foundation and the conservative Heritage Foundation show Maine could save $690 million over the next decade from Medicaid expansion. Maine is one of ten states that will see Medicaid expenditures go down over ten years.

As Kaiser Health explains:

Because the ACA envisioned low-income people receiving coverage through Medicaid, people below poverty are not eligible for Marketplace subsidies. Thus, some adults in Maine fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for premium tax credits . . . People in the coverage gap are ineligible for financial assistance under the ACA, while people with higher incomes are eligible for tax credits to purchase coverage.

So, because LePage rejected ACA money, working people have to pay the full premium, even working people at the poverty level, thus spending more than people who earn more than them.

And these folks are nearly one in five, 19 percent, of the uninsured people in Maine before the ACA. They are identified in the graph above as “in the coverage gap.”

January 1st also marked the end of coverage under the Dirigo Health Agency, Maine’s health-care reform. Republican Gov. Paul LePage campaigned to dismantle the Dirigo Health Care Reform Act by systematically eliminating its funding. LePage was adamant in his attack on the Dirigo Health Act, despite the fact that more Mainers have become healthier with the act’s reforms, and many lives were saved.

Most of the 7,400 or so Mainers still covered by the Dirigo Health Care Act’s insurance arm, DirigoChoice, will find plans through the insurance marketplaces created under the Affordable Care Act. Dirigo’s programs saved lives by helping thousands of uninsured people gain access to medical care and enabled more than 1,000 small businesses to provide insurance for their owners and employees. DirigoChoice insured more than 40,000 Mainers and became a model for President Obama’s ACA.

Signed into law in the 2003, the Dirigo Health Care Reform Act was a bold step toward universal health coverage during a time when policymakers in Washington, D.C. and in Statehouses struggled to take even small steps. A few years later, Governor Romney of Massachusetts used elements of Dirigo in his health-care program.

“In many ways, Dirigo was a pace-setter and blueprint to national reform,” said Trish Riley, former director of Maine Governor John Baldacci’s Office of Health Policy and Finance.

Similarities of the Health-Care Reforms:

• making sure preexisting conditions are covered
• extending the time young adults can be on their parents’ insurance plans
• reducing the ranks of the uninsured or under-insured
• encouraging preventive care
• expanding coverage for maternity care and mental health
• controlling ballooning medical costs
• and getting young people into the insurance pool.

Maine set a standard for states, and the nation, to follow with health-care reform. Transitioning Dirigo to the ACA would have been easy and still can be — if the Legislature is successful in passing an emergency bill by a solid two-thirds of lawmakers, or if LePage has a change of heart.

The two-thirds vote is needed to overcome any veto LePage may put on the measure.

The impact that an uncaring society has on the economy is hard to calculate, but it certainly damages our image not to mention the soul of our state to stand by and do nothing to help.

Our veterans fought for us; how can we deny them health coverage and remain proud to be a citizen?

According to a Harvard study, Maine could prevent around 395 deaths per year by accepting federal funds.

Contact your state lawmakers and let them know you won’t let any more people die in Maine because they lost their health insurance.