Group: Expand health program

AUGUSTA — Labor unions, small businesses and religious groups are calling for an expansion of DirigoChoice, the government-subsidized health insurance program begun this year. The new coalition called Mainers for Health Care is asking that enrollment caps be lifted - or at least raised - so more people can sign up, a proposal under consideration by the program's coordinators.

Coalition members say that job cuts proposed at military bases in Kittery and Brunswick could increase the importance of DirigoChoice, which provides subsidized health insurance on a sliding scale.

"DirigoChoice provides hope for the future for workers in transition," Ned McCann, the secretary-treasurer of Maine AFL-CIO said Tuesday at the State House. "This is a critical time. This is not a time for us to be cutting back on our health care."

Current guidelines allow DirigoChoice to enroll 4,400 individuals who are self-employed or unemployed, or do not get health coverage through their employer.

The Dirigo Health agency, which oversees the insurance program for the state, expects to hit the cap when new enrollments take effect this month. It has stopped quoting rates for individuals.

The cap was established for Anthem Blue Cross Blue Shield of Maine, the program's carrier, as a way to protect the company from the risk of insuring individuals. There are no limits on DirigoChoice's other target: employees of small businesses.

The fear was that sicker patients who face expensive policies on the individual market would flood the program to take advantage of group rates. A contingency fund was set up to protect Anthem from unexpected losses.

Because the program has been running for six months, officials have a better sense of who's in the program. Last week, the Dirigo Health agency pitched a change in the cap to Anthem, said Kirsten Figueroa, the chief financial officer of Dirigo Health.

Neither Figueroa nor Anthem lobbyist Katie Fullam-Harris would comment on the details of the proposal, pending negotiations. Figueroa, though, said Dirigo Health asked to have a resolution take effect by Aug. 1.

Critics of DirigoChoice say they are not surprised by the proposal; they see it as a move to boost enrollment, which stood at 6,366 people as of May 1.

"It makes sense that they're trying to get sole proprietors to join since they can't seem to get small businesses to join and they've had some luck with sole proprietors," said Tarren Bradgon of the Maine Heritage Policy Center.

DirigoChoice has long been a target of conservatives and Republicans who say it was an ill-conceived component of Gov. John Baldacci's Dirigo Health reform law. Critics say it ignores other ways to reduce health insurance costs, such as health savings accounts and scaling back the kinds of coverage that insurance companies are required to provide.

But to Barbara Weiss, a waitress and college student from Augusta, DirigoChoice is the right answer for her family, which is uninsured.

Weiss, 43, said the program also would have been helpful when the family did have insurance.

Past insurance plans had high deductibles and very limited coverage, Weiss said at a news conference organized by the coalition at the State House. A medical bill related to her son's staph infection ended up costing $7,000 and took the family a decade to pay.

DirigoChoice, on the other hand, would provide insurance "that is affordable given our income and coverage that is comprehensive and there when you need it," said Weiss, who is now on a waiting list for DirigoChoice.

Members of the coalition include the Roman Catholic Diocese of Portland, whose lobbyist spoke about the moral imperative of health care coverage, Consumers for Affordable Health Care, the Maine Council of Senior Citizens and small businesses.

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