Cathy Gavin’s letter Sept. 2 mischaracterizes the findings of a study completed by the Muskie School of Public Service regarding the status of those who joined DirigoChoice in its first quarter of operation. Gavin takes issue with the relevance of the study’s findings about the under-insured. She suggests that policymakers should focus only on the uninsured.

Our study found that among DirigoChoice enrollees who switched from other coverage, 40 percent had deductibles in excess of $2,500. High deductibles were disproportionately concentrated in the lowest income families for whom out-of-pocket costs can represent a severe hardship. For example, among DirigoChoice enrollees with family incomes less than $23,500 (about 40 percent of enrollees) a $2,500 deductible is more than 10 percent of household income. Our survey confirmed that those who had been paying high deductibles were more likely to report doing without health care during an illness due to costs.

It is appropriate to draw attention to the fact that DirigoChoice is filling a need for low income people who had been under-insured and were delaying or avoiding needed care. Gavin is correct that there are those who can afford to pay $2,500 or more out of pocket for health care. But she is incorrect to imply that we put a “spin” on our findings. Our study shows that there are significant numbers who could not afford the cost of high deductibles and were going without care and chose DirigoChoice as a more affordable plan.

Beth Kilbreth,

associate professor, Muskie School of Public Service, University of Southern Maine

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