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Saturday, June 12, 2004
Only one insurer submits Dirigo bid
Copyright © 2004 Blethen Maine Newspapers Inc. | ||||||
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Also on this page: WHAT IS DIRIGO HEALTH? | |||||
The state's largest health insurer is the only company willing to provide coverage for the state's Dirigo Health program, but says it needs more time to prepare for the undertaking. Anthem Blue Cross Blue Shield - the sole insurer to submit a bid to the state by the Friday afternoon deadline - said it would be impossible to begin offering coverage by late summer, the state's tentative deadline. The extension would further delay the nationally recognized program, which is designed to cover thousands of uninsured Mainers through affordable plans and subsidies. The state already pushed back a July 1 launch because it needed extra time to design individual and small-group products for Dirigo Health. "We have said to the state (that) with the amount of internal work that would have to be done, it would take us probably closer to six months," said Anthem spokesman Bill Cohen. "You could have people sign up in October," Cohen said, "but the product couldn't begin until January." Consumer advocates are eager to see the program start soon, and Gov. John Baldacci's administration said the start date is still subject to negotiations in the coming weeks. The administration's focus Friday, however, was praising Anthem for attempting to be a good corporate citizen in Maine and moving Dirigo Health closer to reality. "We're delighted," said Trish Riley, director of the Governor's Office of Health Policy and Finance. "We need only one insurer, so we're happy they're in." Anthem already insures about 500,000 Mainers. Dirigo Health would be a private-public enterprise with the insurer providing the benefit and the state pricing the plans on a sliding scale. Discounts would be available to people living under 300 percent of the federal poverty level - about $28,000 a year for a single adult and $56,500 for a family of four. By early July, a review team will make a recommendation to the Dirigo Health Board on whether to accept Anthem's bid or "if there are any concerns or tweaking we need to do," Riley said. The contents of the bid would not be made public until then. "You want to have an unbiased review," Riley said of the reason not to disclose the details of Anthem's bid, "and not a lot of discussion out in the world that would compromise the review." If the bid is unacceptable, the state has the option of asking the Legislature to create a nonprofit insurance agency. But Riley said that is not a top consideration. "We've put that way on the back burner, because now we have a bid from a very well-respected company that's the biggest insurer in Maine and we intend to work with this bid," Riley said. Others, however, wish more bids had come in. Joe Ditre, executive director of Consumers For Affordable Health Care, worried that Anthem can now negotiate better reimbursement rates for itself and persuade the state to postpone the program's launch. Ditre said he also was concerned that a delay would give Anthem time to introduce new products to compete with Dirigo. Anthem spokesman Cohen shrugged off "cynics." "We're working on stuff, but we don't have anything planned to roll out that would be in competition or ahead of Dirigo," Cohen said. Anthem's general manager in Maine, Jim Parker, said the company wants to handle Dirigo Health because "we saw it as another opportunity to help extend coverage." The partnership also makes financial sense for Anthem, he said. "I think it's a good thing that we're constantly trying to keep or expand our company base," Parker said. "The things we do to expand membership only make us more competitive." Anthem's closest competitor in Maine, Aetna, said news of Anthem's bid was not worrisome. "We are comfortable with our strategy, and today's news isn't expected to change that," said spokeswoman Wendy Morphew of Aetna, which covers 86,000 people in Maine.
Staff Writer Josie Huang can be contacted at 791-6364 or at:
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