• Aetna
• Anthem Blue Cross and Blue Shield
• Harvard Pilgrim Health Care

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• MEGA Life & Health

• Supplemental Medigap Insurance
• Medicare Advantage Insurance

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• SecureHorizons by UnitedHealthcare
• Sterling Insurance
• Universal American

Implications for Maine Health Insurance

Implications for Maine

Presuming the evolution of a national health care initiative in the next few years, what can and should Maine do to best position its citizens?

Ironically, the Dirigo Health Plan may ideally position Maine to serve as a pilot for the Obama administration's reform initiative. If, as initially indicated, the federal program is grounded in the establishment of a "standard" plan that is available to individuals who do not or cannot qualify for an existing, current option, Dirigo could be re-engineered to serve as this option. In many ways, this evolution would be entirely consistent with Dirigo's original goal to serve as an affordable program for the uninsured and underinsured. As a pilot for the federal program, additional funding and support are likely to be available and help resolve Dirigo's perennial funding challenges which are largely due to premium and cost-sharing subsidies that were provided to low income Mainers.

In addition to maintaining the Dirigo program as a potential pilot to the federal program, policymakers can continue to identify and advance policies which:

• Promote the efficient and effective delivery of health care services. As noted in this brief, insurance costs are largely a function of the underlying cost of health care services. These costs can be positively impacted by:
• • Eliminating duplication and redundancy in service capacity. Maine's certificate of need (CON) and state health plan are two important instruments for meeting this objective.
  • Advancing patient centered medical homes. There is an evolving crisis in the availability of primary care services. Patient centered medical homes, which are grounded in primary care practices, offer to transform the financing and delivery of primary services in order to attract and retain these providers.
• Advance informational transparency that empowers consumers and providers. The Maine Quality Forum, an important agency created by the Dirigo legislation, is working with private organizations such as the Maine Health Management Coalition, Maine Health Information Center and others to identify and communicate quality and efficiency indicators that better inform value based purchasing of health care services.
• Educate Maine citizens as to their roles and responsibilities in advancing and maintaining good health practices that include but are not limited to tobacco and alcohol consumption, obesity and accident prevention. Rhode Island and New Hampshire have recently required health insurance companies to dramatically reduce premium costs for a small group product that explicitly requires consumers to comply with a set of good health practices.
• Advance a sustainable private insurance market in Maine. As already noted, federal reform is likely to be grounded in the current array of health insurance programs that meet established qualifying criteria. For Maine citizens, the opportunity to select a health plan from an array of current as well as hopefully new options will be welcomed.