Provisions to eliminate lifetime benefit caps and introduce tax credits for small businesses that provide health insurance start immediately.  Others like the individual mandate and health insurance exchanges won’t take effect for another four years.  That is a huge challenge confronting reformers.

In 2003, Maine created Dirigo Health, one of the most significant health reform initiatives by any state.  Like the current national reform, several key Dirigo provisions took time to implement.  Opponents used this transition to undermine program support and chip away at its scope and impact.

National reform advocates should heed Maine’s experience.  While passing comprehensive legislation was a monumental accomplishment, maintaining its integrity may be an even greater challenge.

Maine is well-positioned to realize significant benefits from national reform.  Since many of Maine’s consumer protections mirror provisions in the new federal law, opponents can no longer argue that Maine is at a competitive disadvantage with other states.  Other provisions in the new federal law will complement Maine’s efforts to modernize our health data system and reform the way we pay for health care to address both quality and cost.  Because we have already expanded MaineCare eligibility and created DirigoChoice, the state can more rapidly deploy federal funds to improve Mainers’ access to affordable coverage.

Maine is at the forefront of comprehensive health care reform.  The landmark reforms Congress just enacted affirm Maine’s efforts and increase the likelihood they will flourish.  But reformers at the state and national level must remain vigilant and continue to work together to deliver quality, affordable health care for all.

Jane’s dad has been on dialysis for five years and is awaiting a kidney transplant.  Her mom was diagnosed with breast cancer and had a mastectomy this summer.  As if this wasn’t enough, doctors discovered that Jane (not her real name) had cancer while performing an appendectomy and removed the tumor during a subsequent surgery this fall.  Luckily at 21, Jane is as resilient as ever and has managed to keep pace with her studies.

Jane and her family have insurance.  Unfortunately, they could only afford a high deductible plan and Jane’s father, who is on Medicare, fell into the infamous “donut hole” – a place where despite being covered you’re on the hook for the cost of certain prescriptions.  Fortunately they live in a supportive community and Jane’s mom works for one of the most compassionate and community-minded businesses around, a locally owned grocery store.  Otherwise, it is hard to conceive of how she could have kept her job and maintained what health insurance she has during the many appointments (her own, her husband’s and her daughter’s) she has had to endure.

Stories like these are a reminder that those who wish to stonewall health reform and who claim that the free market and personal responsibility are the solutions to our health care woes are sorely mistaken and have long since lost sight of the human toll of our ideological machinations.

One bright spot from the world of health policy comes once again from Maine.  House Majority Whip Seth Berry has introduced a bill that would forbid coverage caps for health insurance.  This means that people with chronic or life-threatening maladies won’t be cut off from coverage when they need it most.  Already insurance companies have decried this proposal saying that it will boost premiums.  Of course, they’re not willing to say by how much.  In any given year, few people actually hit their cap and the incremental cost spread across all premium holders is likely minimal. 

MECEP is a proud member of a coalition that supports the proposal to forbid health insurance coverage caps.  The hearing for this proposal, L.D. 1620, is 1 p.m. on Wednesday, February 6.