Maine Enacts Universal Access To Health Coverage Plan
First In The Nation Law May Be A Model For Other States

by Joseph P. Ditré, Esq., Ex. Dir.,
Consumers for Affordable Health Care
Last updated on 6/1/04

Maine has an active and collaborative consumer advocacy community. Groups like Consumers for Affordable Health Care, the Maine Equal Justice Project, and the Maine People's Alliance have worked on various initiatives to expand and strengthen private and public health coverage for the past 15 years. Pioneering work by Consumers for Affordable Health Care over a ten-year period with small businesses spawned a host of organizing projects focused on small businesses that were critical to laying the groundwork for health care reforms including the Governor's plan. In addition, a new initiative, called Mainers for Health Care by the Maine State Employees Association/SEIU Local 1989, provided three staff persons and important resources to the efforts to move real health reform in Maine. Moreover, a new Ford Foundation funded organization, called the Maine Small Business Alliance, provided a progressive business voice to the debate. Successful legislative efforts in 2001 to provide affordable coverage to self-employed and small businesses dovetailed well with the Governor's plan.

In addition to the long-term organizing efforts, the Governor's Office of Health Policy and Finance convened a 26-member Health Action Team in early 2003 that completed its work by mid-March to build public and key constituency support for the Dirigo Health Plan. The Team included consumers, Medicaid advocates, representatives of senior and disability groups, organized labor, small and large employers, insurers, hospitals, health care providers, and legislative liaisons. GOHPF made clear from the outset that the Team's charge was not to develop a plan or to build "consensus" for the Governor's plan, rather it served as a "sounding board" to fine-tune the Governor's plan and to identify areas of common interest through its subcommittees. Using the broad ranging work of the Team and its subcommittees as rationale, the Governor got legislators, who had submitted their own health reform bills, to abandon their piecemeal proposals and to get behind his more comprehensive plan. This was fundamental to consolidating legislative support behind one plan without distraction.

The GOHPF staff used grants from HRSA and Maine's conversion foundation to obtain actuarial data, financial modeling, and Medicaid policy analysis to build the plan and its components. Cindy Mann, J.D., a research professor at the Institute for Health Care Research and Policy at Georgetown University, provided indispensable information about state and federal Medicaid policy. Mathematica Policy Research, Watson and Wyatt, the Muskie School at the University of Southern Maine and the National Academy of State Health Policy conducted various surveys and prepared actuarial, financial and other data and modeling on Maine's uninsured and underinsured populations with a focus on self-employed persons and small businesses.

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