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HEALTH REFORM IN MAINE AND MASSACHUSETTS by Bruce Bullen

Both Massachusetts and Maine have embarked on significant health reform journeys. Harvard Pilgrim is proud to be helping in both states and believes that each state could learn important lessons from the other.

Here in Massachusetts we have enrolled hundreds of thousands of uninsured individuals in a very short period of time. Many factors have contributed to this achievement, but chief among them are the long-term funding commitments of state government, businesses, stakeholders, and the federal government in the form of a Medicaid waiver that provides substantial funding. As a result, subsidies available to low-income individuals are very generous, and the premiums of the majority of new health reform enrollees are entirely subsidized. While we have made progress enrolling the uninsured, recent reports warn that the cost of the program will be exceeding budgeted expectations at about the time the federal waiver comes up for renewal next year.

Maine on the other hand has fallen short of its enrollment targets. Unlike Massachusetts, Maine has not had a ready source of state funding, nor has it been successful in obtaining federal support.

As a result, in order to fund its program Maine has had to rely on a controversial assessment that pits stakeholders against one another. Limited funding has meant less generous subsidies than in Massachusetts but has also meant that enrollment growth and the cost of the subsidies have been carefully managed.

Two important lessons that Massachusetts can learn from Maine’s experience are that program costs must be controlled and that federal support for the program must be retained. Maine can learn from the Massachusetts experience that broad consensus on state-level funding is key to the successful financing of expanded access. The nation can learn from both states that innovative approaches to helping the uninsured should be encouraged, funded and replicated.

Bruce Bullen
Chief Operating Officer
Harvard Pilgrim Health Care

This program aired on December 7, 2007. The audio for this program is not available.

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