September 12, 2013

Maine tackles the rising cost of health care

The state, ranked fifth in per-capita health spending, is devising strategies for efficiencies when Obamacare arrives.

By Joe Lawlor jlawlor@pressherald.com
Staff Writer

States have begun tackling an issue that has vexed employers, individuals and governments at all levels for years: trying to control the rapidly rising cost of health care. Maine has an especially difficult task because it ranks fifth among the states for per-capita health care costs, according to 2009 federal statistics.

click image to enlarge

In this December 2012 file photo, Peggy Akers, a nurse practioner who volunteers at the India Street Public Health Clinic in Portland, examines Charles Lafland during a physical exam at the clinic. States have begun tackling an issue that has vexed employers, individuals and governments at all levels for years: trying to control the rapidly rising cost of health care. Maine has an especially difficult task because it ranks fifth among the states for per-capita health care costs, according to 2009 federal statistics.

Gregory Rec / Staff Photographer

Health spending per capita

     Avg. annual growth   1991-2009

 Percent growth

United States

$6,815

6.50%

Alabama

$6,272

5.90%

Alaska

$9,128

8.40%

Arizona

$5,434

7.80%

Arkansas

$6,167

6.60%

California

$6,238

5.90%

Colorado

$5,994

7.30%

Connecticut

$8,654

5.80%

Delaware

$8,480

7.70%

District of Columbia

$10,349

4.50%

Florida

$7,156

6.90%

Georgia

$5,467

6.60%

Hawaii

$6,856

6.20%

Idaho

$5,658

7.90%

Illinois

$6,756

5.80%

Indiana

$6,666

6.30%

Iowa

$6,921

6.10%

Kansas

$6,782

6.20%

Kentucky

$6,596

6.70%

Louisiana

$6,795

5.70%

Maine

$8,521

7.40%

Maryland

$7,492

6.60%

Massachusetts

$9,278

6.40%

Michigan

$6,618

5.60%

Minnesota

$7,409

7.00%

Mississippi

$6,571

7.00%

Missouri

$6,967

6.70%

Montana

$6,640

7.00%

Nebraska

$7,048

6.90%

Nevada

$5,735

9.20%

New Hampshire

$7,839

7.60%

New Jersey

$7,583

6.00%

New Mexico

$6,651

7.70%

New York

$8,341

5.90%

North Carolina

$6,444

7.90%

North Dakota

$7,749

6.20%

Ohio

$7,076

5.80%

Oklahoma

$6,532

6.70%

Oregon

$6,580

7.50%

Pennsylvania

$7,730

5.70%

Rhode Island

$8,309

6.30%

South Carolina

$6,323

7.30%

South Dakota

$7,056

6.90%

Tennessee

$6,411

6.60%

Texas

$5,924

7.30%

Utah

$5,031

7.90%

Vermont

$7,635

7.30%

Virginia

$6,286

6.90%

Washington

$6,782

7.30%

West Virginia

$7,667

6.30%

Wisconsin

$7,233

6.70%

Wyoming

$7,040

7.60%

"We are a very rural state, we are the oldest state in the nation, and older people have higher per-capita health care costs. And we don't have a lot of competition in our health care markets," said Mitchell Stein, public policy director for Maine-based Consumers for Affordable Health Care.

Maine's health care costs averaged $8,521 per person in 2009, the most recent year for which statistics are available from the Centers for Medicare and Medicaid Services.

Some states, including Maine, are devising models to control health care costs that ultimately will determine whether President Obama's Affordable Care Act can make good on its name.

Millions of people will soon gain eligibility for health insurance under the federal law, adding pressure on the system. States, insurers and medical groups are experimenting with various programs to contain costs without undermining care.

The Affordable Care Act is expected to extend coverage to many of the roughly 50 million Americans who now lack insurance by expanding Medicaid, the state-federal health care program for low-income people, and requiring most others to buy insurance or pay fines.

Maine received $33 million in federal money for a three-year "state innovation" grant to cut down on red tape and improve efficiency and service in Medicare, Medicaid and the private health care market.

The grant aims to reduce waiting room times, improve access to primary care and urgent care centers, and better coordinate doctors, patients and insurance companies, according to the Maine Department of Health and Human Services' website.

The grant, which runs from 2013-15, will also help the state devise payment models to increase incentives for doctors to spend more time with patients.

While the innovation grant will help, Stein said, working at cross purposes is the state's failure to approve Medicaid expansion.

While Democrats pushed for covering more people with an expanded Medicaid program, Gov. Paul LePage – like many Republican governors who oppose the Affordable Care Act – vetoed attempts this year to do so. The federal government would have paid for 100 percent of the expansion for the first three years, and 90 percent in subsequent years.

The Affordable Care Act was passed in 2010 with the assumption that states would expand Medicaid. But the U.S. Supreme Court ruled in 2012 that states could opt out of the Medicaid expansion, and Maine decided to forgo expansion.

Stein said that if the state had expanded Medicaid, more low-income residents would have had health insurance and gotten more cost-effective medical care, such as primary care rather than costly emergency room visits.

He said the state faces hard-to-change challenges – such as its age and rural character – that will make reducing health care costs difficult.

The lack of major urban centers in Maine exacerbates per-capita health care costs, Stein said. While many states have large swaths of open land with few people, they also have cities with much larger populations than Maine's, Stein said. Competition in the health care industry in big cities limits costs in those states, Stein said.

Controlling health care costs, experts said, will be a focus for many years to come.

"Look at any of the long-term projections for the federal budget or for state budgets," Alan Weil, executive director of the National Academy for State Health Policy, told The Associated Press. "If we don't bring down health care costs, we're either going to be paying a whole lot more in taxes or we're going to stop spending money on other things we care about."

(Continued on page 2)

Were you interviewed for this story? If so, please fill out our accuracy form

Send question/comment to the editors




Further Discussion

Here at PressHerald.com we value our readers and are committed to growing our community by encouraging you to add to the discussion. To ensure conscientious dialogue we have implemented a strict no-bullying policy. To participate, you must follow our Terms of Use.

Questions about the article? Add them below and we’ll try to answer them or do a follow-up post as soon as we can. Technical problems? Email them to us with an exact description of the problem. Make sure to include:
  • Type of computer or mobile device your are using
  • Exact operating system and browser you are viewing the site on (TIP: You can easily determine your operating system here.)