September 18, 2019
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Historic Dirigo Health Plan passes Baldacci plans to sign measure for uninsured workers next week

AUGUSTA – More than 180,000 uninsured Mainers could eventually enjoy health care benefits as a result of landmark legislation approved by the lawmakers Friday under the guidance of Gov. John E. Baldacci.

Dirigo Health Plan, the first-in-the-nation universal health care plan, received overwhelming support in the House and Senate, but not without first experiencing a little turbulence en route to enactment.

LD 1611 failed to receive two-thirds majorities in either body during initial votes, prompting supporters to strip the bill’s emergency preamble, which would have allowed the legislation to become law immediately after it was signed by the governor. By removing the preamble, a simple majority was all that was needed to pass.

Ironically, the measure did receive supermajorities once the emergency language was removed, passing in the House 105-38, and the Senate 25-8. Next week, Baldacci plans to sign the bill, which will become law 90 days after the Legislature adjourns.

Senate GOP leader Paul Davis of Sangerville theorized that the eight dissenting Republican votes in the Senate were from lawmakers who were unhappy that majority Democrats killed their proposed amendment to the plan Thursday. Earlier that same day, those same dissenting senators had voted in favor of the bill.

“Their amendment was indefinitely postponed and they weren’t given any chance to talk about it, so there you have it,” he said. “They decided to vote against the whole thing.”

Senate Majority Leader Sharon A. Treat, D-Farmingdale, said a lot of changes already had been made to the Dirigo plan to bring Republicans on board. Democrats, she said, had no choice but to kill the GOP amendment offered Thursday.

“Their amendment would have completely gutted the Dirigo plan – it replaced the entire bill,” she said. “It was a stark choice between going with the Dirigo plan and going with something that didn’t do anything that Dirigo did.”

Baldacci and proponents downplayed the loss of the emergency language, which they said had been attached by the Health and Human Services Committee when its members unanimously approved the bill. The governor said the only real setback triggered by the removal of the emergency provision was the loss of funds necessary to immediately set up an administrative board.

“It was not critical to the implementation of [the plan]” he said. “We’ve gotten to the point where we have overwhelming bipartisan support. That’s important. We want the citizens to know this is not a political issue. This is an issue about their health and the health of our economy.”

House Majority Leader John Richardson, D-Brunswick, said lawmakers didn’t seem to grasp that once the bill had enough votes to pass, it would have been just as logical to give it two-thirds support.

“By not doing so it means that we’re delaying measures to be taken on health care reform for a couple of months,” he said. “I think these people flip-flopped [on the final vote] because they don’t want to be on record for having not supported health care.”

In addition to the Dirigo plan, the Legislature also addressed a proposed constitutional amendment that would have prevented lawmakers from withdrawing tobacco settlement money from the Fund for a Healthy Maine for nonmedical purposes or during economic downturns to help pay the state’s bills.

The efforts to secure the supermajority demanded by the measure failed Thursday and there was little hope of reaching that goal Friday. Proponents instead chose to have the bill recommitted to the Health and Human Services Committee and carried over to the January legislative session for further consideration

Late Friday evening, the House and Senate were concluding final pieces of business in order to adjourn. Some lawmakers held out little hope that a $95 million bond package for November being sought by the governor would be resolved, since many Republicans favored a lesser amount. In contrast, some Democrats wanted a larger proposal than Baldacci’s.

Another major piece of legislation that remained unresolved Friday was the governor’s fiscal reform package that had become bogged down in competing strategies for cost-savings and tax reform. Baldacci and legislators want to turn out a competing measure to appear on the November ballot with the Maine Municipal Association’s citizen’s initiative that guarantees the state will pay 55 percent of local education costs.

Both issues now appear destined to be taken up during a special one-day legislative session, expected to be scheduled for June 27. It is likely that lawmakers also will act at that time on any gubernatorial vetoes – including those on bills advocating Maine’s entry into the Powerball lottery game and installing slot machines at off-track betting facilities.

Earning strong bipartisan support Friday, the Dirigo Health Care plan has not been without its critics. Some Republicans claimed the legislation would force insurers to raise their rates in Maine and discourage others from continuing to do business in the state.

The initiative was a major component of the governor’s election campaign. The final product, however, was clearly the result of months of negotiations between hospitals, health care providers, insurance companies, the governor’s staff and the Legislature.

Under the plan, which would become effective next year, a new agency composed of private and public interests will provide health care coverage for 180,000 Mainers through arrangements with private insurers. The legislation also expands eligibility under a Medicaid program known as MaineCare.

In addition to providing health care services to many who cannot afford them, the Dirigo plan seeks to rein in costs associated with the delivery of medical services in the state. Participation in the program would be voluntary and eligibility would be extended to those who are self-employed or employed by companies that do not offer health insurance.

The law stipulates that a Dirigo participant must work a minimum of 20 hours per week for a participating employer, who would be required to contribute as much as 60 percent of the premium costs.

Some of those who are self-employed or employed by non-Dirigo companies would pay 100 percent of the insurance premium.

The governor is setting up the program with $52 million from Maine’s estimated $115.6 million share of a $20 billion state aid package U.S. Sen. Susan Collins of Maine helped push through Congress last month.

Other sources of financing for the initiative include a 4 percent fee on gross revenues received by insurance companies operating in the state; premiums paid by employers and the self-employed; and Medicaid benefits formerly collected under MaineCare.


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