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AUGUSTA — Last
weekend’s snowstorm cancelled a state-sponsored
focus group on “Tough Choices” in health care.
This quieted
Republican criticism that the 1,000-person forum
was simply a setup by the Baldacci
administration to get the answers it wants on
curbing hospital costs and implementing health
care mandates.
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“High-Risk Pool” Would
Lower Insurance Rates, Say Proponents |
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By
Victoria Wallack
Statehouse News Service
AUGUSTA — Maine’s health
insurance rates are among the highest in
the country, ranking in the top five
nationwide. Republicans say it’s time to
create a high-risk pool here to get some
of the sickest among us out of the mix.
At a press conference Tuesday, Republicans called for support of
legislation that would create that pool
and eliminate the state requirement that
an insurer must issue a policy to
anyone, regardless of medical condition
or risk status.
The legislation also would allow insurance companies to set
premiums based on a person’s current or
previous health conditions — not
dissimilar to the way auto insurance is
priced based on a person’s driving
record.
Joe Ditre of Consumers for Affordable Health Care said what the
Republicans are advocating is “survival
of the fittest.”
“They want to allow insurance companies to drop coverage for the
oldest and sickest people,” Ditre said,
and force higher-risk people out by
raising their rates beyond reach.
The state passed legislation in the early 1990s to protect those
people, requiring that premiums be based
on a “community rating” system. This
allows insurance companies to vary
premium costs only according to a
client’s age, occupation and where he or
she works, instead of personal history.
Republicans say these requirements have made insurance so expensive
for everyone that consumers can’t afford
to buy it. Insurance companies have left
the state because it’s too expensive to
compete.
They used examples provided by Anthem showing that a family of
four, with parents at age 40 and two
children, would pay $514 for a monthly
premium in Louisville, Ky., but $1,781
in Westbrook, Maine.
Rep. Kevin Glynn (R-South Portland) is sponsoring two bills to
change the system. Rep. Ken Lindell
(R-Frankfort) is sponsoring a third.
According to the Republicans, 40 states use experience rating in
their small group market and only four
states still have community-rating laws
as strict as Maine’s.
“Community rating does not work,” Glynn said. “All Mainers pay more
for their health insurance because of
it.”
The high-risk pool being proposed would cover those with
pre-existing and chronic illnesses who
could be deemed “uninsurable” by
insurance companies because of their
high risk. The proposed legislation
would take the most expensive clients
out of the general system, making rates
lower for the rest of those enrolled.
The problem, according to Ditre, is that the premiums for those in
high-risk pools are exorbitant and most
consumers can’t afford them. In many
parts of the country, the states are
forced to subsidize the pool.
Republicans are proposing that the high-risk pool be subsidized
with 60-cents-a-month surcharges on
individual policies.
The proposed bills are now heading to the Insurance and Financial
Services Committee for review. |
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Organizers say
the group was intended to provide an unbiased
opinion on what tradeoffs Mainers are willing to
make to bring health care costs down and get
better service.
The focus group
— planned for sites in South Portland, Augusta
and Brewer — was being put on with $350,000 in
grant money and being run by the national
nonprofit organization AmericaSpeaks, which
Republicans characterized as a liberal
organization. Its founder did do consulting work
for the Clinton White House and Al Gore.
Saturday’s
snowstorm forced the state to call off the focus
group on Saturday. Because of the limited
availability of AmericaSpeaks, the session has
not yet been rescheduled.
The state
invited more than 1,000 residents to
participate, culling the names from an original
list of 25,000. Participants were chosen to
represent a cross section of ages, sexes,
occupations and income levels.
The group was
going to vote on various aspects of the proposed
state health plan or policy blueprint, now being
developed by the administration as part of the
Dirigo Health legislation passed in 2003.
Topics ranged
from capping hospital and insurance costs to
taxing unhealthy habits in order to discourage
smoking and overeating and help pay for health
care initiatives.
Ellen Schneiter,
deputy director of the Governor’s Office of
Health Policy and Finance, said an invited focus
group format was chosen rather than an open
forum to prevent special interest groups from
stacking the meetings.
“If you open the
door to anybody, you get the same cast of
characters,” she said, explaining that at other
Dirigo Health meetings when the audience is
asked if they’re attached to the hospitals in
some way, “they all raise their hands.”
Sen. Carol
Weston (R-Waldo), assistant minority leader,
said the focus group appeared “very contrived,”
and she questioned AmericaSpeaks’ role, saying
it “certainly has a partisan past.”
Sen. Richard
Rosen (R-Hancock), currently serving on the
Health and Human Services Committee, said “this
is like a staged, paid, invitation-only event.”
Participants were to be paid mileage and
child-care costs.
“This is just
the beginning of the conversation,” Schneiter
said of the focus groups before they got
cancelled. “We don’t know what they’re going to
say.”
The Maine Health
Access Foundation, formed when Blue Cross and
Blue Shield was sold to Anthem in Maine, gave
the administration $300,000 toward the cost of
the focus group. That same organization has
funded the marketing for DirigoChoice health
insurance, to the tune of $557,000. |
