Portland Press Herald / Maine Sunday Telegram
MAINE VOICES Dirigo Health costs more, 'saves' less each year
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Other states offer more insurance products at lower prices than Maine does. Why?
Tarren Bragdon October 2, 2007
ABOUT THE AUTHOR

Tarren Bragdon is the director of health reform initiatives at the Maine Heritage Policy Center. He can be reached at tbragdon@MainePolicy.org.

— The acting state superintendent of insurance recently released the estimate of how much Dirigo Health has "saved" Maine's health-care system in its third year of operation.

The $32.8 million savings figure was so unimpressive that even the governor did not issue a press release about it.

Regardless, this annual escapade of consultants, actuaries, lawyers and bureaucrats gathering, calculating and debating the impact of Dirigo Health only serves as a distraction.

The fact remains that Dirigo Health is costing more and more each year while "saving" less and less, and has not resulted in any significant drop in the number of uninsured.

From its operational beginning in late 2004 through June 2007, Dirigo Health has cost Maine taxpayers almost $100 million. The first $53 million of that was financed by federal funds originally negotiated by Sen. Susan Collins to help offset state and Medicaid cuts during the budget crisis in 2003.

The rest is financed by turning the above-mentioned "savings" into a tax on private health insurance claims that increases the cost of private coverage.

This claims tax, benevolently called the Savings Offset Payment, is combined with a 2 percent ($20 million) tax on all non-HMO health insurance premiums paid by small businesses, sole proprietors and individuals buying insurance from non- employer sources.

In 2006, the state made more in taxes on health insurance than the combined in-state profits of all insurance companies.

Currently, Dirigo Health administration costs taxpayers $3.3 million a month. In its first full fiscal year, Dirigo Health Agency had net costs of $13 million, $21.7 million in the second year and over $37 million in the third year.

The $32.8 million in Dirigo "savings" in its third year follows $43.7 million in "savings" in the first year and $34.3 million in "savings" in the second year. Unbelievably, Dirigo Health is saving less despite costing taxpayers more.

In fact, the very thing that Dirigo Health spent the vast majority of funds on -- the DirigoChoice insurance product -- produced the least amount of documented savings.

In fiscal year 2007, Dirigo Health spent over $30 million on Dirigo Choice, after deducting employer-paid premiums and net employee contributions. And the superintendent calculated that this $30 million expenditure resulted in less than $3 million in savings.

The net savings was an unimpressive 10 cents for every dollar spent.

All other savings were attributed to funding in the Medicaid programs and hospitals voluntarily limiting cost increases, with no help from the state in doing so.

In 2003, when Dirigo Health was passed with the promise of eliminating all uninsured by 2009, Maine had 128,000 uninsured residents or 10 percent of the population. In 2006, that uninsured figure was 122,000 or 9.3 percent of the population, after $100 million was invested on the Dirigo Health initiative.

In fact, Maine's flat uninsured rate mirrors U.S. trends for the similar national population.

There is an alternative: Maine government can do more to make private health insurance more accessible and more affordable to its residents.

First, Maine can give Mainers and small businesses access to the same affordable health insurance plans available in other New England states.

For example, almost half of all uninsured adults in Maine are between the ages of 18 and 34 and in good health.

In New Hampshire or Connecticut, these young immortals have access to individual health insurance plans for as little as $100- $200 a month for a comprehensive policy.

In Maine, a similar $1,000 deductible plan costs over $700 a month, with an 18 percent increase scheduled for next year.

Second, Maine can stop taxing health premiums and health care, which increases costs by 4 percent or more.

Taxing something does not make it more affordable, it makes it more expensive.

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