Maine Medical Association: Dirigo is good

“We like Dirigo,” said Gordon Smith of the Maine Medical Association, which represents doctors. “The DirigoChoice product is run through a commercial company which pays commercial rates. It doesn’t create the problem we have with MaineCare (reimbursements)” because DirigoChoice makes full payments.

The MMA’s highest priority is getting people covered, Smith said. “DirigoChoice coverage is pretty good. Whether it covers 100,000 or 10,000 people, it’s still covering people who were uninsured or under insured.”

With federal health reform coming, “absolutely, Dirigo should be kept around,” he said. “It’s an essential vehicle” and will give Maine a head start.

Maine Heritage Policy Center: Scrap it

“Dirigo has been a costly failure by every measure, whether it’s state dollars or now a big check from the feds,” said Terren Bragdon, chief executive officer of the Maine Heritage Policy Center, a conservative think tank.

The program fails “if you look at the impact on the uninsured, how expensive the program has been compared to what it was projected to cost, how few it is reaching, and how it was supposed to impact the individual insurance market in Maine,” he said.

Bragdon said he’d like to see DirigoChoice scrapped.

Other states have more robust markets, in part because they’re less regulated. “They allow a greater number of health insurance plans to be offered, greater flexibility,” he said.

He said the money that DirigoChoice receives from a 2.14 percent fee charged on insurance claims paid in Maine “is a tax by any measure.”

Maine Hospital Association: Plan is irrelevant

“We hardly pay any attention to Dirigo,” said Steven Michaud, president of the Maine Hospital Association. “The Medicaid program is so much larger. It is so broke and is breaking the banks of hospitals.”

MaineCare, the state’s health insurance program for low-income and disabled people, does not fully reimburse hospitals for patient care, and the number of people on MaineCare has grown, he said.

“Dirigo is an afterthought,” Michaud said.

Hospitals like the quality improvement work that DirigoChoice has done, Michaud said. And Dirigo has, to a degree, helped contain costs through hospitals volunteering to constrain budget growth to less than 3 percent a year.

But part of that, Michaud said, is the recession. Hospitals are “cutting costs anywhere you can.”