There is some justifiable concern about LD 290, which would allow the interstate sale of health insurance policies in Maine. Opponents believe it is a disaster waiting to happen, because insurers beyond Maine would erode the state’s regulatory ability to protect the insured here.

This is true. There is no guarantee that if Mainers buy policies from a Connecticut company, they would be protected from harm – or afforded due process – under Maine guidelines. No state has enacted such cross-border sales legislation, so there is no precedent or model to follow.

Yet this argument – however salient – seems a bit of a straw man. Instead of focusing on what guarantees may exist for those who purchase policies from another New England state, lawmakers should remember what is, and has been, guaranteed for consumers who buy policies in Maine, especially individuals.

That would be repeated, relentless double-digit rate increases every two years, which has created conditions in which affordable policies have four- or five-digit deductibles. From a practical perspective, this is essentially no coverage at all, particularly in regard to preventive care.

In this state, which has identified chronic diseases as a primary driver of medical expenses, having Mainers insured in name only is dangerous. Something must be done. But what? In previous years, solutions have been expanded government-backed coverage, such as MaineCare and Dirigo.

These programs have had their qualified successes in providing care. Their finances, though, have mitigated these gains. They have shown an insatiable appetite for money without strong evidence of savings elsewhere. In fact, Dirigo claims its savings through oft-disputed state actuarial calculations.

In the meantime, insurance rates and health care costs still rise. At some point, Maine lawmakers must fight their distaste and fear of market-based reforms and realize that lowering insurance costs cannot come solely through government action. This is a market that must be jolted, but smartly.

We think LD 290 would do that. Its wisdom is its scope – limiting policy sales to New England should allow for development of regulatory protections for Maine consumers. This is a legitimate issue, given that insurers can be masters of doublespeak when it comes to policy protections.

The top issue is not price. This legislation’s value is not bringing down the cost of policies in Maine, rather improving the value of policies that are sold here. If cross-state competition can stop oppressive rate increases and entice companies to offer better coverage with lower deductibles, it should be done, just as it is done for life, vehicle, homeowner and flood insurance.

Just this week, President Barack Obama stood shoulder-to-shoulder with some of America’s biggest players in the health-industry complex to announce plans to trim some $2 trillion from the cost of delivering U.S. health care. This has been hailed with hallelujahs and suspicions.

There are no guarantees that what the president wants to achieve will happen. If there’s one consistent about health care policy, it seems that cost-containment initiatives always seem to spring leaks. The laboratory for reform still remains the states; they should not grant this authority to Washington.

LD 290 is an opportunity to re-open the lab in Maine. Where Dirigo was once the symbol of innovation, so could Maine lead in endorsing smart, limited market reforms, like cross-state sales.


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