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Wednesday, November 23, 2005
Highest possible fee on insurers approved
Copyright © 2005 Blethen Maine Newspapers Inc. | ||||||
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Also on this page: In Depth: Health Care Reform | |||||
AUGUSTA — A state agency decided Tuesday that health insurers should contribute $43.7 million next year to support Maine's fledgling effort to provide coverage to more residents. Supporters of the higher-than-expected fee said it will benefit thousands of Mainers, but opponents said it will hurt residents who already have insurance. Insurers say they will have to factor the fee into rate increases next year, meaning even higher premiums for privately insured Mainers. But state administrators say the decision means 3,000-plus Mainers on a waiting list for the state-sponsored DirigoChoice plan will be able to join as early as January. Covering those people, they say, would help reduce bad debt and charity care in the health care system, a cost shifted onto buyers of private health insurance. The fee, however, may face a legal challenge from the insurance industry or business community, which is worried that employers ultimately will shoulder the expense. The threat of litigation was recognized by the board of directors for the Dirigo Health agency as they debated the size of the fee. But after a five-hour meeting that included testimony from citizen supporters of DirigoChoice, members voted 4-1 to assess insurers $43.7 million starting in January. "I think this is a very significant day," said chairman Robert McAfee, a retired Portland surgeon and former president of the American Medical Association. "We are providing health coverage for more people then we started." Health industry estimates put Maine's uninsured at more than 130,000 people. An unknown number of people are considered "underinsured" because their deductibles are so high. The fee will permit DirigoChoice to provide subsidized health plans to an additional 6,000 people through March 2007. Currently, about 7,300 people are in the year-old program, said KarynLee Harrington, executive director of the Dirigo Health agency. The fee means all people on the waiting list will be able to sign up during the first quarter of next year - from January to March - rather than waiting to be phased in over a 20-month period. Representatives of the insurance industry expressed frustration with the board's decision. A spokesman for Anthem Blue Cross Blue Shield, the state's largest insurer and the private carrier for DirigoChoice, said the company was disappointed that members did not go with a $31.3 fee million proposed by the staff of the Dirigo Health agency earlier this month. Rather, the board will assess the full amount allowed under law. That cap was set when Superintendent of Insurance Alessandro Iuppa determined that DirigoChoice and other reform initiatives of the Dirigo Health law had saved Maine's health care system $43.7 million. The Dirigo Health board reasons that those savings should trickle down to insurers in the form of reduced rates from hospitals and other health care providers. But representatives of the insurance industry said they have recaptured all the savings they can and that it is not fair to assess a fee on savings they have not seen. They also say the superintendent attributed more savings to the Dirigo Health law than it deserved. The Maine Association of Health Plans, which represents Aetna, Cigna and Harvard Pilgrim, is contemplating an appeal of Iuppa's decision, said Katherine Pelletreau, executive director of the insurance trade group. The deadline to appeal the decision is Monday. The Maine State Chamber of Commerce said it is also considering an appeal. The one dissenting vote on the board came from Dana Connors, president of the state chamber. Connors said he had hoped to approve a fee lower than $31.3 million. He wanted to deduct $7 million that was budgeted to cover more Mainers with dependents under the state Medicaid program, MaineCare. Connors said he would like to cover more people through DirigoChoice but was uncomfortable allocating money for MaineCare because it is already included in the state budget. Connors, however, was part of a unanimous vote that had the board committing to keeping one item on its agenda: making sure the fee is not passed on to consumers. The other voting members on the board are Carl Leinonen, an organizer for the Service Employees International Union; Mary Henderson, executive director of Maine Equal Justice Project; and Charlene Rydell, a policy adviser for Democratic congressman Tom Allen. The fee, which will be based on each insurance company's paid claims, would also pay for the operation of the state watchdog group Maine Quality Forum. It would replace a $53 million allocation from the Legislature that is scheduled to run out next spring.
Staff Writer Josie Huang can be contacted at 791-6364 or at: IN DEPTH: HEALTH CARE REFORM LEARN MORE ABOUT the Dirigo debate in the special section about health care reform at MaineToday.com
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