Wall St. Journal

 

Others Join Maine in Push
For Health-Care Change

Associated Press
December 26, 2006; Page D4

 

The national spotlight shone on Maine's universal health-care access program when it was launched two years ago. Now Maine is being joined by Massachusetts, Vermont and a number of other states looking at health-care overhaul.

Laura Tobler, a health-policy analyst with the National Conference of State Legislatures in Denver, said she has never seen so much health-care overhaul activity bubbling on the horizon as now. While Massachusetts and Vermont have created overhauls that will be implemented in 2007, other states appear poised to create revisions of their own in the year ahead, she said.

"California, Minnesota, Ohio, Wisconsin, Colorado and New Mexico are all states that have momentum this coming year," she said. "And that's just off the top of my head. That doesn't mean in January there won't be several more states with plans for comprehensive health-care reform."

Maine's Dirigo Health Reform Act drew national attention when it was signed into law in 2003, making Maine the first state in recent years to enact legislation aimed at providing universal health-care access.

The law, which went into effect Jan. 1, 2005, is designed to contain health-care costs and ensure access for all. When it passed in the Legislature, its goal was to insure 31,000 people in its first year and to cover all of the state's 130,000 uninsured by 2009.

The program has fallen short of its goals -- 12,153 were enrolled in the Dirigo Choice health-insurance program at the end of October -- and was placed under review this year by a commission representing business, insurers, consumers, labor and the state.

This year, Massachusetts has drawn attention with legislation passed in April to reorganize its health-care insurance markets and subsidy system. The aim is to reduce the number of uninsured covered by the government, while expanding the ranks of those who insure themselves through private programs. The new law affects an estimated 500,000 or more people and makes Massachusetts the first state to mandate near universal health coverage.

Vermont's Catamount Health, passed last May, is a state-subsidized program designed to help people without insurance buy it on their own in the private marketplace. It goes into effect in October.

Other states appear ready to jump on the bandwagon, said Chris Conover, a professor in the Center for Health Policy at Duke University. In particular, they look to Massachusetts' example and wonder if it can be duplicated. "I think there are aggressive governors who say, 'Why can't we do that?' " Mr. Conover said.

Ed Haislmaier, a research fellow at the Heritage Foundation think tank in Washington, speaks to groups nationwide about what's going on in Massachusetts. He gets the occasional question about Maine's Dirigo Health and other programs in New York and Maryland, he says, but most of the interest is in Massachusetts. States are interested in health-care overhaul because growing costs are eating up state budgets, but the challenge is substantial because each state has a unique set of factors, he said.

Some states' biggest concerns, for example, are their large numbers of immigrants, while others might have to address rural needs, lack of competition among hospitals or health-insurance companies, or complex regulatory systems. The longer he studies the subject, said Mr. Haislmaier, the more convinced he is that states have to customize revisions to their particular needs.

In Maine, the commission began looking at Dirigo in July to explore how to cover more people, fund the program and contain costs, among other things. Last week, the commission approved a set of recommendations that includes looking into the idea of mandated employer group coverage for workers and requirements for individuals above certain income levels to get coverage for themselves. The commission also expressed support for new taxes to expand the program.

Copyright © 2006 Associated Press