AUGUSTA – Maine’s DirigoHealth program will begin accepting new enrollees Aug. 1 because of federal funding made available under the health care reform law passed earlier this year.

The $17 million provided by the Obama administration will help insure an estimated 900 people with pre-existing conditions, DirigoHealth Executive Director Karynlee Harrington told board members Monday.

“This is a good extension of what we do today. It’s our target population, people that have been uninsured and they are sick and they need coverage,” she said in an interview Monday.

The federal funding is meant to provide coverage for people with pre-existing conditions who may have been denied coverage or who could not afford insurance premiums because of their illnesses. Covering people with pre-existing conditions who couldn’t get health insurance is one of the key reforms in the new health care law.

Maine law already prevents insurers from denying such coverage, but other states allow it. And not all Mainers with pre-existing conditions could afford their premiums, even though they were eligible for coverage, which is where the additional federal money will help.

Harrington said there are 7,200 people enrolled in what’s called DirigoChoice, and an additional 6,500 people who are parents of children in MaineCare and are receiving subsidized health coverage.

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“We’ll use DirigoChoice, and what the federal funds allow us to do is pay for the additional costs associated with individuals who have been uninsured and have serious medical conditions,” Harrington said. “So (the money) allows us to do two things: one, cover more people than we would otherwise be able to cover, and two, help stabilize the premiums for these folks.”

Harrington said she’s sure there will be interest in the expansion, but whether people will meet the various requirements is unknown.

Mia Poliquin Pross, director of policy operations for Consumers for Affordable Health Care, said new federal money for Dirigo is one example of how the new health care law will improve coverage and access to coverage for Mainers.

Pross said other reforms in the new law include the creation of health care exchanges in 2014 — marketplaces for individuals and small businesses to shop for coverage together across state lines. Officials expect the combination of increased bargaining power and added competition to lower premiums.

 


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