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Lessons from Maine

The Connecticut General Assembly  is considering SB194, which would change the process by which insurance companies obtain rate increases in the individual insurance market.  I offered some perspective before the Insurance and Real Estate committee, drawing on our experience in Maine.

New York’s High Costs to Go Nationwide

New York’s individual health-insurance market is not often held up as a national model, and for good reason. It’s the most regulated, most expensive and, as a result, one of the smallest in the country, with only a few costly health plans available.

Since New York policymakers inflicted costly regulations on insurers in 1994, enrollment in the individual insurance market has plummeted by 96%.

Current prices are staggering. In New York City, the cheapest individual plan costs $9,036 a year for a single person and $26,460 for a family. In contrast, the Congressional Budget Office estimates the average national family premium at $12,000 to $15,000 a year.

Yet both the House and the Senate health-reform bills would make the rest of America look more like New York’s dysfunctional market — and then force New Yorkers to foot a larger share of the trillion-dollar cost.

Only five states now have New York-style insurance regulations, but both bills force those rules on all 50 states and then force people to buy coverage or face tax penalties. Think about it: If 45 states don’t regulate insurance like New York does, there is probably a very good reason. And there is: These regulations drive up costs and limit choices.

Adding insult to expensive injury, Congress also plans to expand Medicaid coverage. Here, too, New York is an example of what not to do. The Empire State has the most expensive Medicaid program in the country — spending as much as Texas, Florida and Illinois combined.

New York’s Medicaid program is the fourth largest among all the states as a percentage of the population enrolled, yet the state’s rate of uninsured ranks 24th highest in the country. Of the 26 states with a lower rate of uninsured than New York, only two have a larger share of residents on Medicaid.

Clearly, doubling down on Medicaid is not the right path to universal coverage — yet Congress wants to push millions of Americans into Medicaid and thrust new costs onto the states.
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A Tax Penalty of $2,250 per Family

The Senate will likely vote soon on a Motion to Proceed with debate on Senator Harry Reid and the Senate Democrats’ Health Reform Bill. Make no mistake, this Motion to Proceed is the first critical vote in this debate and will require 60 votes to move ahead with this costly, government takeover of U.S. health care.

Consider these costly facts about the Reid Bill:

• 2,074 pages (more than the Pelosi Bill that barely passed the U.S. House thanks to Congressman Michaud’s last minute support).
• Costs $2.5 trillion over 10 years of full implementation (2014-2023).
• Has $494 billion in tax increases, including a tax penalty of $2,250 for each family that does not buy government-approved health insurance. See all tax increases.
• Includes a government-run plan, that, according to the Congressional Budget Office, would “typically have premiums that were somewhat higher than the average premiums for the private plans in the exchanges,” much like Maine’s experience with Dirigo as the NYTimes and Sean Hannity have recently noted, highlighting research by The Maine Heritage Policy Center.
• Mandates that states spend an additional $25 billion in Medicaid expenditures, including a mandated 13% expansion of Maine’s already huge Medicaid program.

After many conversations with Senator Snowe and Senator Collins, and their staffs, we have every reason to believe that both Senator Snowe and Senator Collins will vote NO on the Motion to Proceed with debate on this House-approved, big-government health care overhaul.

Learning from Maine

The U.S. House passed 2,000+ page bill late Saturday night that includes many ultra-liberal features that will doom the plan in the U.S. Senate.  It would create more than 100 new federal agencies with untold control over the lives and decisions of American citizens.  The fast-and-loose budget tricks which make the bill appear fiscally viable crumble at the slightest examination.  For a good review of this, read a column by Michael Tanner of the CATO Institute here: The Cost of Health Care Reform

Maine has a great deal to teach the other forty-nine states about a so-called “Public Option” because the state started one here in 2004 called Dirigo. This experiment has been a total failure, as shown in this recent report on the Sean Hannity program. If you haven’t seen this excellent video, please click here:  The Maine Lesson.

Lesssons From Maine–Broadcast Nationwide

Last night the Sean Hannity Show included a detailed report on Maine’s attempt to create a “public option” plan.

I was among those interviewed in this extensive segment, which includes viewpoints from supporters of Dirigo as well.

The Bottom Line on Dirigo is quite clear: When Dirigo was passed in 2003, it was supposed to cover all 128,000 uninsured by this year - not raise taxes, lower health care costs and decrease health insurance premiums.

In reality:

• For DirigoChoice – the government plan – premiums are up 74 percent in four years.
• Maine has 21,000 more uninsured today than before Dirigo went into effect in 2004. Maine now has the second-highest uninsured rate in New England.
• Dirigo covers fewer than 3 percent of Maine’s uninsured today, despite spending $155 million of your taxes so far.
• The Legislature recently passed a new tax on health insurance claims to continue funding this failure – a tax that will cost the typical Maine family another $300 per year!

Sen. Snowe and the Baucus Bill

I appreciate Senator Snowe’s engagement and commitment to meaningful, bipartisan health reform. Her vote today reflects a continued commitment to that process.

However, I have real concerns with the Baucus Bill. If enacted as is, the Finance Committee bill will drive up premium costs, limit choices and raise taxes on Maine families and businesses. I am also very concerned with the bill’s impact on Medicare, given Maine’s status as the oldest state in the nation.

That’s not the kind of health reform Maine needs now, particularly during a recession and at a time of record deficit spending in Washington.

Skating on Potomac River Ice in the Middle of a “Snowe” Storm

It never ceases to amaze me how the busiest woman in Washington remains so accessible.  Just this week alone, I am aware of 8-10 hours of direct Washington senior staff time devoted to Maine doctors, patients and health care professionals in reviewing the impact of the Baucus bill on Maine families and businesses. 

Impressive. 

Unfortunately, it would appear that there are a number of folks in Washington who are unwilling to make the same time commitment, as they rework one-sixth of our economy.

Sen. Olympia Snowe (R-Maine) laid out her understanding of the need for "full consideration" during the health care debate in a statement she released on her website on September 22:

Given the gravity of this landmark endeavor… there should be no question this undertaking commands a painstaking process and the requisite time for full consideration of the spectrum of alternatives and improvements…and to ensure the numbers "add up" within the final product – as we are the only committee of jurisdiction with respect to financing a package.  The implications of this legislation are simply too broad and monumental to do otherwise.

Senator Snowe's statement is pretty straight forward. She believes that members of the Senate Finance Committee should be able to read the bill and know how much it costs — a sentiment she shares with her constituents back home.

On the following day, September 23, Senate democrats voted down an amendment proposed by Republican Senators Bunning and Cornyn, which would have required that the actual legislative language and a final Congressional Budget Office price tag be posted for 72 hours on the Committee website for public review. This would occur before the Senate Finance Committee could vote on final passage.

One way to easily get a sense of how irritated Senator Snowe is on a particular issue, is to time the release of one of her "statements" to the actual event to which it is referring.  Think of it like a thunderstorm – where you time how far apart the lightning and thunder are to judge just how close the storm is. I would say the storm is directly over head at this point as Snowe's statement flashed on her website shortly after the vote. She did not mince words saying,

"The fact is words matter and so do the numbers.  This amendment represents a common sense, practical, pragmatic, good government approach to understanding the totality and the collective impact of what we do. We want to be sure that we are absolutely confident in the integrity of the product that we are going to be voting on in the final analysis."

Let me translate that statement for the Democrats on the Senate Finance Committee. You are skating on Potomac River ice in the middle of a Snowe storm.  It's not going to end well.  When she uses words like "common sense"  "practical" and "pragmatic" in the same sentence – you might want to consult with your Senate colleagues on the Right.  They learned to speak Moderate in the previous Administration.   The grimace on their faces -followed by a Cheshire cat smile- should be translation enough.

The way I see it — Senator Snowe and her staff have work tirelessly to save the health care bill from complete implosion by offering a series of amendments designed to breathe new life into the reform effort –and perhaps provide the Gang of Six a little more time to work out some type of bipartisan bill.  She continues to be accessible to folks back here in Maine, and her staff is speaking daily to doctors, state legislators, other health care professional as well as patients — in an attempt to find solutions that will work for Maine people.

I can assure you right now – that reading the bill and knowing how much it costs are the first two items on Senator Snowe's health care reform agenda and the same goes for her constituents back here in Maine.  The failure of Democrats on the Finance Committee to recognize that fact may very well signal the end of any hope for bipartisanship in health care reform.

After Starting “Universal” State Insurance Program, Maine has MORE Uninsured

The U.S. Census Bureau last week released updated information on the number of uninsured people in Maine. Maine's number of uninsured is now 21,000 higher than pre-Dirigo (2004) and the second highest in New England. In contrast, the number of uninsured in neighboring New Hampshire has dropped, despite the fact that New Hampshire's Medicaid program is less than half as large as Maine's.

The numbers speak for themselves. The promise of Maine's public option experiment was to cover all of the state's uninsured people by 2009 through Dirigo Health. Unfortunately, after spending more than $155 million in taxpayer funds and raising taxes on private health insurance to fund the Dirigo experiment, we now learn that Maine has more uninsured people than before Dirigo began.

The Dirigo policies are expensive with premiums skyrocketing 74% in four years, the benefits have been reduced, the program has been closed to new enrollees for two years, and the taxes to pay for this scheme actually make other health plans more expensive. How much worse does it have to get before Maine politicians can admit that this is not working and should not be duplicated by Congress with a federal government plan like Dirigo?

Two weeks ago, Health and Human Services Secretary Kathleen Sebelius was in Maine to announce that millions of federal dollars will be spent to help prop up Maine's Dirigo disaster. Here are several questions that she did not answer, but should have. Given the lack of success in trimming Maine's uninsured population, how can Maine's leadership possibly justify taking federal money, during a time of unprecedented federal deficits, to prop up Dirigo?

The latest US Census Bureau figures show Maine's number of uninsured climbed by 22,000.

• Maine now has 136,000 non-elderly uninsured, up 22,000 from last year and up from 115,000 in 2004, the first year before Dirigo was implemented (DirigoChoice began covering people on Jan 1, 2005).
• New Hampshire, with an almost identical size population, actually experienced a drop in the number of uninsured, from 136,000 in 2007 to 131,000 in 2008, despite the fact that NH's Medicaid program covers 97,000 people compared to Maine's 223,000 for this same non-elderly population.
• Maine (at 12.3%) has the second-highest percent uninsured of all the New England states – NH (11.5%), CT (11.4% ), VT (10.6%), MA (6.3%) and RI (13.4%) and the highest in northern New England.

Sebelius Visits Maine, Ducks Questions

Last week, President Obama's Health and Human Services Secretary Kathleen Sebelius was in Maine touting a costly plan – read more about the five questions that she did NOT answer and about Washington's latest attempt to buy Maine votes using government pork.

Also, the US Senate Finance Committee is floating the idea of a fee on insurers to fund $900 billion government-run health care plan. This sounds eerily familiar to the Dirigo Savings Offset Payment and is a costly tax by just another name. In Maine, the Dirigo Tax adds up to $300 to the annual costs of private family health insurance.

Memo to White House: No Snowe in the Forecast

The email dings started around 10:00 pm, and continued throughout the night as folks throughout Maine sent me the latest report on CNN.com that quotes "sources" who claim, "President Obama and top aides have quietly stepped up talks with moderate Republican Senator Olympia Snowe of Maine on a scaled-back health care bill, according to two sources familiar with the negotiations."

I know that Washington DC folks spend a great deal of time in an alternative world, but seriously – Senator Snowe engaged in behind the scenes talks with the President? Forget for a moment that Senator Snowe has been working on health care issues since President Obama was in grammar school, the real issue here is that Senator Snowe doesn't need to do anything behind the scenes with the White House, or anyone else for that matter.

I met with her personally during the August recess back here in Maine when she talked to dozens of Maine folks in a series of health care talks throughout the state. Here is what I learned: She is worried about costs and the impact on the deficit, the public option plan is "off the table", she wants more private insurance companies in Maine (we have 3), and she doesn't support higher taxes – especially during a recession.

Those concerns and opinions were not from "unnamed sources," they were straight from Senator Snowe. And just to be certain, I spoke to her chief of staff and her health care legislative aid yesterday morning. There is nothing new – other than the fact that Senator Snowe continues to be committed to working for health care reform with her colleagues in the "gang of six" and that "nothing has changed that would justify the CNN story."

I think the fundamental problem here is that the folks at the White House – who are very likely spinning this story in an attempt to pressure Senator Snowe – are totally misreading the way she operates. While the "moderate" labelis often used by the far right to protest Senator Snowe's actions – the left is about to learn a very important lesson from the Moderate from Maine.

It is not an act. It is not something Senator Snowe does to get re-elected or to curry favor. She believes that there is middle ground and she looks for it. For her, middle ground means giving businesses the opportunity to join together and purchase health care – regardless of state lines. It involves tort reform,it involves ensuring folks have skin in the game (not "free" government health care) and it involves truly bending thecost curve. The bottom line is that Democrats in Congress, and this President, have failed to find the middle ground in the health care debate. In fact, they have veered so far off the center that they will find no sympathy – behind the scenes or not – from Senator Snowe or her other moderate colleagues.

As for the other "White House" strategy where CNN reports, "Allies of the president hope that if Snowe accepts a health care agreement, she might also bring along her Republican colleague from Maine, moderate Senator Susan Collins." Don't hold your breath.

In fact, watch and listen to this video. Sen. Collins rejects the public option, and the health care reform effort in her own words, as she responds to a question from an SEIU member. (The relevant part starts at 55:25 and runs for two minutes).

So, my suggestion to the White House: put away your shovels, there is no Snowe in the forecast.