June 18, 2018
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Health Care Considerations

Gov.-elect Paul LePage and his transition team have said a lot about their intent to gut state and federal health care reform. Before they move in this direction, they need to acknowledge what improvements have come from these reforms. This is especially important after a federal judge Monday ruled that the individual mandate portion of the federal health reform law is unconstitutional.

The LePage administration needs to see what Maine has done well — and what it has not — so it can make smarter decisions about state health care policy.

Last week, Gov.-elect LePage said he would pursue having Maine join a lawsuit by several other states to overturn the health reform law passed by Congress last year. The push to repeal all or part of the historic health reform act gained steam with the Virginia judge’s ruling, the first to invalidate a portion of the package, most of which does not go into effect until 2014.

District Court Judge Henry Hudson wrote that in passing the individual mandate — a requirement that all Americans buy health insurance — Congress violated its authority under the Constitution’s Commerce Clause. There will be no immediate stoppage of provisions of the law, portions of which are already in effect, because Judge Hudson rejected the plaintiff’s request to halt implementation of the law pending appeal.

If the law is invalidated, the incoming governor must be prepared for the ramifications. Will the state’s soon-to-be governor allow young adults to be booted from their parents’ insurance plans? Will he allow Mainers with pre-existing conditions to be denied insurance?

Shortly after the November election, Tarren Bragdon, a member of Mr. LePage’s transition team, bragged that the Dirigo Health program, which aimed to reduce insurance costs and extend health coverage to more people, would soon be “Dirigone.”

Dirigo Health has been plagued with problems since its inception, but eliminating the program will have consequences. What will happen to the 13,000 people who now get their insurance through the program? Will they join the ranks of the uninsured? Will they be covered by plans with $15,000 deductibles?

Dan Demeritt, a spokesman for Gov.-elect LePage, acknowledges that people rely on Dirigo Health and that others ways to provide them with health insurance need to be found before Dirigo could be considered for elimination.

Here are some things to keep in mind as the new administration and Legislature look for other ways to address health care and insurance costs:

ä The percentage of people without health insurance has dropped significantly in Maine. Maine ranked 19th in covering the uninsured in 2003. Last year, the state was ranked sixth, according to America’s Health Rankings.

ä From 1999 to 2003, average family premiums in Maine grew by more than 50 percent, compared with 38 percent nationally.

ä From 2003, when Dirigo reforms began, to 2008, premium costs grew at 9 percent in Maine, versus 14 percent nationally. During that same time, the average annual deductible actually went down, while the rest of the nation’s grew at double digits.

As the LePage administration considers what to do with Dirigo and how to respond to the national health care law, it can’t lose sight of the progress that already has been made.

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