We’re glad somebody, finally, is talking about Dirigo Health.
This week, the Legislature’s Insurance and Financial Services Committee heard bills regarding the struggling state-subsidized health insurance program, which has been a missing person since voters rejected a bevy of new beverage taxes last November to pay for it.
Nothing has changed. Dirigo enrollment is still capped and far below expectations; the waiting list is still there; it still costs more money than it brings in; and lawsuits regarding its current source of funding — the Savings Offset Payment — still remain pending.
Yet the need, now, for the program has never been greater. As job losses mount and the economy stalls, government must intervene to ensure businesses can provide insurance and individuals can afford to purchase it, especially given the increasingly expensive market for individual policies here in Maine.
But Dirigo remains a colossal problem. It is a victim of lofty expectations and promises, a shaky funding design and taxpayer revolt against a last-minute blast of legislative chicanery regarding the beverage taxes.
The program is now weakest when it is arguably needed most, in both the fiscal and reputation senses. This should dictate the Legislature’s thinking and priorities when it comes to Dirigo — is what is needed additional, stable revenue, or restoration of public confidence in the program?
For our money, we’d say the latter.
Gov. John Baldacci and Rep. Sharon Treat, D-Hallowell, have introduced legislation to scrap the Savings Offset Payment for a flat 2.14 percent tax on paid insurance claims. The bills, which had public hearings Tuesday, would raise $42 million per year, according to the Kennebec Journal, while introducing an understandable and predictable funding source. 
While this would solve problems, namely ending the controversial SOP,Dirigo’s reputation cannot be laundered with money alone. Dirigo is overdue for an evaluation of its effectiveness and goals, which have shifted mightily from its early, heady days of vowing near-universal coverage to its current role as niche product between the market and MaineCare.
Rep. Sarah Lewin, R-Eliot, has introduced legislation to have Dirigo reviewed by the Office of Program Evaluation and Government Accountability. Although this office does fine work, we’d go further and ask an outside firm with health care expertise, akin to the McKinsey & Company that studied Maine’s overall government operations for efficiency, to do this job.
Federal stimulus money is being targeted to boslter Dirigo in the short term, according to State House News Service, which provides a window for a review to occur. (A good thing, too, because Dirigo’s credit with the state’s cash pool is also apparently running out.) An accounting and evaluation of Dirigo’s past and present would give lawmakers, officials and the public a clear glimpse at the future.
A weak program isn’t strengthened by funding but rather, enabled. We know Dirigo needs additional, dedicated money, but we don’t know whether it will make a difference in its outcome. It hasn’t yet worked as intended. But does this mean it won’t work in the future? We don’t know.
A detailed evaluation of Dirigo could help tell us.

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