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

While the commitment was strong among Democratic legislative leadership to pass Dirigo Health, rank and file members of the Legislature in rural districts were attacked by their local hospitals for supporting the plan. These local hospitals threatened closure and huge layoffs if the plan were enacted. The hospital attacks were orchestrated by the Maine Hospital Association that focused on a voluntary "global budget" provision in the original legislation. The provision would have set up a working group that included representatives of hospitals, other medical providers and the GOHFP staff to negotiate an annual "expenditure target" based on the "hospital cost index." Hospital spending growth in Maine exceeds 10 percent on an annual basis adding about $225 million in 2002 to the health bills of businesses and consumers. Hospital association representatives confided that they would not accept an "expenditure target" at any level because of the "principle." They were aimed at softening some of the more aggressive cost containment provisions in the original bill. The hospital attacks were not supported by all hospitals. Given the strong cost controls in the enacted plan, it is unclear how successful these efforts were. However, the hospital attacks clearly slowed momentum and were widely perceived by the media and the public as "gutting" cost controls. On the other hand, the hospital attacks outraged many legislators who said that the hospitals had misrepresented the voluntary nature of the cost controls and had misinformed their workers that they would be laid off if the plan was passed. Moreover, consumer advocates believe the hospitals overplayed their hand by revealing rapidly rising hospital costs that are clearly unsustainable.

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