Maine to provide universal health care

AUGUSTA, Maine (AP) -- Other states have tried -- and failed -- to create universal health care. Now, Maine intends to show them how it's done.

This summer, the state will begin enrolling people in its health care program, called Dirigo -- the state motto and Latin for "I lead." It is aimed at ensuring health care access for all 1.3 million residents.

Under the voluntary program, people will be able to get health coverage through private insurers at rates subsidized by the state and participating employers.

The program is fraught with uncertainty: How much will it cost when fully in place? How many employers will participate? How much will they have to contribute? And, perhaps most important, can the state pull it off as planned without a broad-based tax increase on individuals or businesses?

"Making something like this work anywhere is an experiment. And we will all learn in the process," said Jay Wolfson, professor of public health and medicine at the University of South Florida.

The program is designed to fill the gaps between private insurance and Medicaid that leave 160,000 persons in Maine uninsured. It aims to sign up 31,000 persons this year. All uninsured residents would have access by 2009.

"No other state currently has as far-reaching a plan as Maine," said Howard Berliner, a health policy professor at New School University in New York City.

The plan was championed by Gov. John Baldacci, a Democrat who made universal coverage a cornerstone of his campaign.

Even with the modest initial goal, the program will cost about $90 million in the first year, according to the Baldacci administration. But beyond that, the costs are not clear.

Officials are banking on voluntary contributions from employers who want to provide coverage to their workers, as well as $52 million in one-time federal money to start up the program.

The state also plans to pay for the program with the money it saves by holding down runaway medical costs. It hopes to save $80 million a year by eliminating unreimbursed medical costs run up by uninsured people, and will try to persuade hospitals and providers to impose price caps.

The uninsured will have to pay premiums to join Dirigo, or obtain coverage through their employers. It is not yet clear how much people will have to pay, but the premiums will be on a sliding scale based on income.

In addition, Maine's Medicaid program will be expanded to cover more poor people. Maine also has a program called Maine Rx that uses the state's buying power to force drug companies to offer bulk discounts on prescription drugs for the elderly, the working poor and others.

The key to success will be the number of employers who sign up, those familiar with the program say.