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The Maine Supreme Court on Thursday ruled 5-1 to uphold a "key funding mechanism" in Gov. John Baldacci's (D) Dirigo Health initiative, through which assessments are issued to insurers based on savings generated by the program, the AP/Portland Press Herald reports. Savings-offset payments are among "the most contentious elements of Dirigo," according to the AP/Press Herald. Former Insurance Superintendent Alessandro Iuppa calculated that the program, which was created in 2003, generated $44 million in savings during its first year. The Maine Association of Health Plans and two other groups sued over the savings figure, arguing that it included additional categories of savings that state lawmakers had not considered when they approved the program. The state argued that the Dirigo board and Iuppa had the expertise to interpret and apply the state Dirigo Health Reform Act, which is designed to restrain health care costs and expand health coverage to the 130,000 uninsured Maine residents. The law is meant to reduce charity care and bad debt for insurers, which are required to return the savings to the state in offset payments. Justice Donald Alexander, the only dissenter, said Iuppa needed specific criteria to estimate the disputed figure. "Reasonable people do differ, and differ geometrically, in guessing at the meaning of the 'cost savings' provision. And the statute provides no guidance as to how these differences may be resolved," he said. State Rep. Anglin Treat (D), who helped promote the passage of legislation that created Dirigo Health, said the decision "validates the system we have in place, and it gives us a great deal of encouragement and hope that in moving forward we can continue to expand this program." Baldacci health care adviser Trish Riley said the provision of the law that was in dispute likely will be changed by the Legislature this session (AP/Portland Press Herald, 6/1). "Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
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