Maine State Specific Strategies

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Dirigo Health Reform Act – This comprehensive state-wide health system reform, enacted in 2003, addresses costs, quality, and access to health care with the goal of establishing universal coverage within six years.  The Act includes a number of cost-containment initiatives, including system-wide health planning, public price disclosure, simplification of administrative functions and reductions in paperwork, and voluntary limits on hospital costs and new rate regulation on insurance premiums.  

The Act creates the Maine Quality Forum, which promotes quality of care initiatives and educates providers and consumers about medical practices and other quality of care indicators. The Act created DirigoChoice,which isan affordable health insurance option for small businesses, the self-employed, and eligible individuals without access to employer-sponsored insurance that offers discounts on monthly payments and reductions in deductible and out-of-pocket costs on a sliding scale to enrollees with incomes below 300 percent FPL.  

Funding for DirigoChoice comes from a variety of funding streams: employer contributions, individual contributions, a one time appropriation of state general funds, federal Medicaid matching funds for those individuals who are eligible andthrough the “savings offset payment” which is generated through the recovery of bad debt and charity care and other savings targets set by the state. 
To learn more about the Maine’s Dirigo program, read SCI’s Profile in Coverage.