Business groups have formed a coalition to fight recent tax increases
designed to shore up Maine’s struggling program to provide state-subsidized
health insurance coverage.
The coalition, Fed Up With Taxes, is made up of a dozen business trade groups
and is leading a drive to put a proposal on the November ballot to repeal the
taxes that state legislators approved in April.
The taxes are to replace a controversial assessment on health insurers that
hasn’t come close to providing the revenue needed to fund DirigoChoice, the
state-subsidized program offered to small employers and individuals.
The coalition will need to obtain the signatures of just more than 55,000
registered Maine voters by July 17 to put the question on the ballot.
The taxes include a first-ever Maine tax on soft drinks, a doubling of
existing levies on beer and wine, and a 1.8 percent tax on health care claims
paid by insurers and third-party claims administrators. The taxes are so
unpopular that coalition members say they are optimistic they will get the
signatures needed to get the repeal initiative on the ballot.
“It is a significant undertaking, but we believe we have a fighting chance,”
said Newell Auger, director of the coalition and head of the Maine Beverage
Association in Portland. “This isn’t about health care. It is about new taxes.
This is about a nonpartisan group that is fed up with taxes.”
State officials say the new taxes will produce roughly double the revenue as
the previous assessment on insurers, while the amount collected will be more
predictable. The previous assessment had been linked to savings achieved by
insurers, with the thinking that providers would shift less uncompensated health
care costs to insured patients as more people had coverage.
The assessments were “contentious and very costly to calculate,” said Trish
Riley, director of Maine Gov. John Baldacci’s Office of Health Policy and
Finance.
Objections have been raised, and “we have tried to meet them,” Riley
said.
The battle comes nearly five years after Maine legislators passed what then
was considered a pioneering approach to drastically reduce the state’s
then-190,000 uninsured. But the program’s achievements have been modest at best
and critics have blasted the plan.
“It has been a colossal, expensive failure,” with the program providing
coverage to only a small percentage of the previously uninsured, said Tarren
Bragdon, CEO of the Maine Heritage Policy Center in Portland.
While once hailed as a model, now “no state is looking to replicate this
failed example,” Bragdon said.
“It is costing $50 million a year to provide coverage to a very small number
of people,” said Chris Hall, senior vice president for the Portland Regional
Chamber. “The costs clearly are outweighing the benefits.”
Just less than 13,000 people now have coverage through DirigoChoice—about 1
percent of the state’s population and a fraction of initial state enrollment
predictions.
“The program has made only a small dent in reducing the number of uninsured,”
said Randy Abbott, a senior consultant with Watson Wyatt Worldwide in Wellesley
Hills, Massachusetts.
Riley acknowledged that DirigoChoice, which began issuing policies in January
2005 and currently offers coverage by managed care provider Harvard Pilgrim
Health Care, is “a work in progress.” But he also said it has enabled about
28,000 Maine residents to obtain health insurance coverage since its
inception.
Still, observers say the program’s basic premise hasn’t come close to being
realized: that the savings resulting from moving the state closer to universal
coverage would be sufficient to fund an expansion of coverage.
In part, observers blame the low enrollment in DirigoChoice on the fact that
it hasn’t, in many cases, made health care coverage more affordable.
“Coverage is still expensive,” said Dave Spellman, president of Pratt
Financial Group, an insurance agency in Westbrook, Maine. In fact, small
employers in some cases may pay more for coverage through DirigoChoice compared
with the traditional market, he said.
That can occur, for example, because DirigoChoice requires employers to pay
60 percent of the premium. How much DirigoChoice pays of the remaining premium
depends on an employee’s income. If an employer had paid only 50 percent of
premiums, its cost could increase by obtaining coverage through DirigoChoice,
Spellman said.
Others say state demographics have a lot to do with the continuing high
number of people without health insurance.
“This is a state with a lot of small employers with many low-wage employees
who can’t even afford subsidized health insurance coverage,” Abbott said.
Filed by Jerry Geisel of Business Insurance, a sister publication of
Workforce Management. To comment, e-mail editors@workforce.com.