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FRIDAY, JANUARY 30, 2004

NATIONAL REPORT CITES MAINE

AS “SUCCESS STORY” IN HEALTH CARE

WASHINGTON, D.C. (January 30, 2004) – An assessment of health care in the 50 states, released here today, singles out Maine for its innovative work in several aspects of state-funded health care. The report appears in the February 2004 issue of Governing magazine.

Governing notes that Maine is the state to watch in the coming year for its innovative health care management efforts. The state’s new prescription drug program, implemented just a couple of weeks ago, uses the buying power the state gets from its Medicaid population to extend discounts to low-income, non-Medicaid residents.

In July, Maine will begin implementing its so-called Dirigo (the Latin for “I Lead”) program, which was described by Governing as “arguably the most ambitious effort” to help reduce the numbers of uninsured Americans. Trish Riley, director of the Governor’s Office of Health Policy and Finance in Maine told the magazine that this program is the “last best test of an employer-based system,” for insuring more people.

The multi-layered approach Maine state is pioneering features state-administered health plans for small businesses and the self-employed. Private insurers will provide the coverage, while the state regulates rates. Maine will also help with enrollment, eligibility determination, wellness programs and disease management, taking a great deal of the administrative load off the back of small businesses that simply don’t have the resources to tackle such tasks.

The program also includes state subsidies to help toward the purchase of private insurance, through employers, for those whose incomes would otherwise qualify them for public help. Those with incomes below 300 percent of poverty, who don’t have employer insurance, will still qualify for Maine Care, the state’s Medicaid and Children’s Health Insurance Program.

“It takes a great deal of courage to embark on this kind of major reform,” says Katherine Barrett, co-author of the report, “because when something goes wrong it can really blow up in your face. But we were deeply impressed by the leadership in Maine, which clearly has the courage of its convictions here. Other states are watching closely to see how the experiment pans out.”

Governing’s analysis of state-funded health care is part of the Government Performance Project, a six-year-old effort, funded by the Pew Charitable Trusts, to evaluate a wide range of state government management and policy functions. This year’s special report focuses on six critical health care problems facing states: long-term care, public health, mental health, prescription drugs, access to care for the uninsured, and care for children.

The Government Performance Project found and documented the inability of the 50 states’ health care system to deliver improvements in medicine fairly and consistently to many of their citizens. Health care in most states is not just inadequate, the study concluded--it’s deteriorating. “After exhaustive analysis and hundreds of interviews,” says Peter Harkness, Governing’s publisher and editor, “it became clear that there is a health care crisis in America. But it is in no way a medical crisis. It is a fiscal crisis.”

Governing is a policy and management magazine aimed at high-level state and local government officials. An online version of this report will be available at http://www.governing.com/gpp/2004/intro.htm as of January 29. Press releases for each of the 50 states can be found at http://www.governing.com/gpp/2004/press.htm.