Dirigo Health
Healthcare in the United States |
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The Dirigo Health Agency (sometimes known simply as Dirigo Health) was a government agency run by the state of
Origins
Dirigo Health was created as part of Maine Public Law 469, also known as the Dirigo Health Reform Act. It was originally presented to the
DirigoChoice
DirigoChoice is a subsidized health insurance program available to Maine businesses with fewer than 50 employees, the self-employed, and other individuals. The program is funded through a one-time grant of $53 million from the state, employer and employee contributions, Medicaid payments, and an ongoing assessment on insurance entities known as the "Savings Offset Payment" (SOP) based on savings attributable to the operations of Dirigo.[3]
In 2002, it was estimated that over 100,000 Maine residents were uninsured. Almost 80% of enrollees have family incomes below 300% of the Federal Poverty Level. 700 small employers were enrolled in DirigoChoice, representing 2.5% of the firms that are eligible. The primary barrier for very small employers appears to be price. The revenues for the program have been lower than expected, creating political pressure to find other funding sources.[4]
Caps on enrollment were put into place in September 2007[6] which remained in place as of the November 2009 enrollment report.[7]
Controversy
Although proponents of the legislation that set up Dirigo Health projected that it could cover 31,000 previously uninsured Maine residents in its first year, the actual figure through the program's first twelve months was 8,600.
The Dirigo Health Agency Board of Directors has been accused of inflating the cost savings from the program to drive up the amount the state can recoup through the SOP. [citation needed] However, the final savings determination of $43.7 million was decided by the state's Superintendent of Insurance. [citation needed] His decision came after an independent and thorough review of testimony provided during an adjudicatory hearing from opponents and proponents to Dirigo. [citation needed] Several organizations within the state, including the Maine State Chamber of Commerce and the Maine Association of Health Plans, of which Anthem is a member, have brought legal action against the state to argue that the SOP is improperly calculated and assessed.
See also
References
- ^ Bragdon, Tarren; Brackemyre, Adam (February 16, 2006). "A SOP to Socialized Medicine".
- ^ a b "Dirigo Health FAQ". Archived from the original on 2006-02-19.
- ^ "Official DirigoChoice site". Dirigo Health.
- ^ Debra J. Lipson, James M. Verdier, and Lynn Quincy, "Leading the Way? Maine's Initial Experience in Expanding Coverage Through Dirigo Health Reforms," The Commonwealth Fund, December 2007
- ^ "Dirigo Board minutes" (PDF). Dirigo Health. October 23, 2007.
- ^ "Dirigo Board minutes" (PDF). Dirigo Health. September 19, 2007.
- ^ "Dirigo Health Monthly Numbers" (PDF). Dirigo Health. November 2009.
- ^ "Dirigo Board minutes" (PDF). Dirigo Health. January 10, 2006.
- ^ "Maine, Anthem Agreement on Dirigo Sets Stage for Universal Health Plan Sales in Oct". Insurancejournal.com. Associated Press. August 24, 2004.
External links
- Dirigo Health
- State Senator Peter Mills on Dirigo Health Archived 2006-07-16 at the Health Departments in the United States
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