AUGUSTA – Mainers who have been uninsured for at least six months and have pre-existing medical conditions will be helped by $17 million in federal money, state officials said Thursday.

The money, part of national health care reform, will serve as a bridge to full implementation of the law in 2014, said Trish Riley, director of the Governor’s Office of Health Policy and Finance.

In Maine, an estimated 500 to 700 people haven’t had health insurance for at least six months and have pre-existing conditions. The money, expected in Maine this summer, is meant to help extend coverage to those who qualify through 2014.

But Riley said $17 million will fall short of what’s needed. “The dollars are just not adequate to do a high-risk pool,” she said.

The 17-member Joint Select Committee on Health Care Reform Opportunities and Implementation met Thursday at the State House for the first time. Riley and other state and national officials updated the panel on federal health care reform and how it affects Maine.

Rep. Sharon Treat, D-Hallowell, said she hopes the panel of 11 Democrats and six Republicans will serve as an accurate source of information.

“The more important goal is to start to map out what this means for Maine,” she said. “We need to figure out the timeline for it and look at what we do in Maine now.”

Riley, the chief architect of the state’s Dirigo Health program, said existing state policies and Dirigo put Maine in a strong position to implement federal reforms.

For example, the high-risk pool can be put into place by expanding Dirigo, she said. But because the state won’t have money to invest, the program will enroll only as many people as the $17 million will cover, she said.

The high-risk pool is just one of many changes to be implemented in Maine and nationally under the federal law. Maine Insurance Superintendent Mila Kofman said she’s studying areas where Maine must update its laws to comply with federal reforms.

She said she’ll go to the Legislature with suggestions in an effort to “keep the federal government out of Maine.”

Joy Johnson Wilson of the National Conference of State Legislatures emphasized the importance of health insurance exchanges outlined in the law. Exchanges will be a place for people to buy insurance if they can’t afford it through the individual market.

“This is the centerpiece of the whole thing,” she said. “This needs to work, and it’s very complicated, and it will be very different in each state.”

Although reforms won’t be in effect entirely until 2014, she said there are key dates earlier. For example, in March, planning grants will be available for states.

Rep. Patrick Flood, R-Winthrop, asked Wilson whether the new law encourages use of Medicaid.

“It makes Medicaid a mainstream health insurance program,” she said. “If you’re below 133 percent of poverty, the exchange will send you to Medicaid.”

Senate Minority Leader Kevin Raye, R-Perry, said he’s concerned that Maine won’t get as much federal money as other states because it already offers more benefits, such as health insurance for adults without children.

“I get pits in my stomach when I think about the impact of this law on the state budget,” he said.

Johnson said that while states that haven’t provided coverage will get full federal funding to expand their programs, Maine will also get additional funds.

“Maine falls into the do-gooder category,” she said. “We argued very strenuously as an organization that states that go further and innovate should not be punished.”


MaineToday Media State House Reporter Susan Cover can be contacted at 620-7015 or at:

[email protected]


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