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Massachusetts health care — wonky, with a healthy dose of reality

Uphill Climb for Maine's Health Reform Law

Uphill Climb for Maine's Health Reform Law

April 30, 2007

Valuable article in today's NYT on the sluggish progress of Maine's Dirigo Health Plan -- click here. Dirigo (Latin for "I lead" -- the state's motto) started with great national fanfare in 2003 as Maine's "universal health care law." The Dirigo program was projected to have 31,000 enrollees by 2005 and up to 130,000 by 2009. As of now, it trundles along with about 13,000 enrollees.

One of the politically attractive features of the original law was its voluntary nature. No one is coerced to do anything -- it's all free choice. In this case, what makes it politically attractive makes it ineffective from a policy perspective. At the end of the day, voluntary approaches can make small progress, can generate friendly press clips, and don't do the job. If the goal is near universal, voluntary will not meet the mark.

Here's the most encouraging part of the piece:

Governor Baldacci said in an interview that when the Legislature enacted the Dirigo Health Reform Act in 2003, it gave him less money and more compromises than he had wanted. He said his administration had now learned more about what works and what does not.

His new proposals include requiring people to have insurance and employers to offer it and penalizing them financially if they do not; making the subsidized insurance plan, DirigoChoice, more affordable for small businesses; creating a separate insurance pool for high-risk patients; instituting more Medicaid cost controls; and having the state administer DirigoChoice, which is now sold by Anthem Blue Cross.

“We’ve got a reform package that takes Dirigo to the next level,” Mr. Baldacci said. “It takes the training wheels off.”

Go for it, folks!