Maine vs. Vermont: Which Approach to Healthcare Reform Will Succeed?

by Angela Chagnon

The Maine Legislature passed their healthcare reform bill May 16 and Maine Governor Paul LePage, a Republican, signed the bill into law on May 17.

Maine’s approach to healthcare reform was markedly different than Vermont’s.  While our state placed all decision-making power into a board of five “smart” people and laid the groundwork for a single-payer system similar to Canada’s failing system, Maine opened up their insurance market and created more choice and competition for Mainers.

The bill, LD 1333, opens the market to out-of-state insurance companies to sell policies in Main and allows small businesses with 50 or fewer employees to band together to create a self-insurance program. The bill also removes community rating, which will expand the market for insurance policies that can be sold in the state, and creates a high-risk pool for those with chronic illnesses and pre-existing conditions.

Maine People Before Politics“, a grassroots organization whose stated goal is to “advance and promote policies that, on the whole, benefit all of the people of Maine,” supported the bill. In an article on its website about LD 1333, the organization writes:

LD 1333 focuses on increasing competition in Maine’s health insurance market by opening up cross-border insurance sales. Under LD 1333 insurers authorized to transact individual health insurance in Connecticut, Massachusetts, New Hampshire or Rhode Island would be allowed [to]offer their individual health plans for sale in Maine.

This legislation is based on the Idaho health insurance model. In Maine, a 20 year old man could expect to pay over $700 a month for health insurance, while the same man in Idaho could expect to pay just over $100. A 60 year old Idaho man would pay about $400 for health insurance, while a 60 year old Maine man would pay more than $1,000 for similar insurance.

Last year, Idaho’s governor signed a bill into law, the “Idaho Health Freedom Act” that required the state’s Attorney General to sue the Federal government over the individual mandate contained in the Federal health care law.

This article by Ariel Hansen explains Idaho’s current shift to “medical home” care. The article’s sidebar gives an explanation of the system:

“The patient-centered medical home is a model of primary care in which patients receive enhanced access to a primary care provider and a clinical care team. In the medical home model of care, services are well-coordinated, and clinicians focus on preventive care, track patient data, and conduct quality improvement activities to meet patients’ needs. The model has demonstrated improved clinical outcomes and patients’ experiences, as well as reduced health system costs.”

– From the Idaho Primary Care Association, citing the Idaho Medical Home Collaborative

Ironically, the Sun Journal, a left-leaning newspaper in Lewiston, Maine, ran an article titled “Who will pay for your healthcare?” on May 15 that blasted Maine legislators for rushing the bill through, while at the same time praising Vermont’s legislature for passing a single-payer bill (H.202).  Vermont’s bill had passed two weeks before the article was published, while Maine’s bill was still being considered by their legislature.

In that front-page article written by Douglas Rooks, he claims that Vermont used a “bi-partisan approach” in crafting H.202.  Rooks included a statement from Gordon Smith, president of the Maine Medical Association, who says: “Bipartisanship has been a part of Vermont’s approach for decades”.

It should be noted that nearly every amendment to H.202 offered by Republicans was defeated by the Democrat supermajority.  Two exceptions were Rutland Republican Senator Kevin Mullin’s amendment and Rep. Francis “Topper” McFaun’s (R- Barre Town) amendment regarding collective bargaining rights. The bill passed mainly on party lines.

Smith admits that Vermont will need to somehow find funding for its plan:

“Still, even with robust federal funding, Vermont will need a public revenue source to replace private premium dollars.  That could be a sticking point, said Smith, who added that it certainly was for Maine.”

It may well be a “sticking point” for Vermonters who feel that they already pay enough taxes.  Especially since the state has struggled to find funding for its existing programs and to bridge the “budget gap” of $176 million this legislative session.

Anya Rader Wallack, health care policy adviser to Governor Shumlin, was also quoted in the Sun Journal article.  She says of Vermont:

“We tend to have a cooperative environment for hospitals.  The evidence is clear that hospital competition, such as you have in the Boston area, tends to drive up prices.”

This statement is in direct contradiction to Governor Shumlin’s own words.  During a March press conference, Shumlin stated, “The problem with healthcare is that we have no competition to speak of in Vermont.”

Vermonters should be relieved that the “smart people” are in charge.