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Health Care Costs
Maine employers today are facing double-digit health insurance
premium increases. This is forcing many employers to drop or reduce
coverage—or require employees to pay larger co-pays and deductibles.
At the same time, individuals who purchase their own coverage
are finding it more and more difficult to afford coverage. Maine’s
escalating insurance premiums are likely a result of a multitude
of reasons such as initial territorial pricing by managed care
companies, adverse selection (guaranteed issue), other health
insurance reforms, medical inflation, cost-shifting, consumerism
and administrative burdens. In addressing health insurance premiums,
a distinction must be drawn between those factors affecting premium
that pertain to underwriting, pool size and other rating factors
versus those factors that are relative to direct health care costs
and increasing utilization.
Meaningful and expanded access to Maine’s health care delivery
system is dependent on success in expanding access to health insurance
coverage and improving cost efficiencies while maintaining excellence
in quality medical care. The public/private partnership must be
strengthened to ensure that public payers are paying their fair
share. Medicaid and Medicare must pay for the costs of caring
for their enrollees. We must identify opportunities to improve
the affordability of commercial health insurance to maintain and
increase employer-sponsored plan. A greater percentage of the
health care dollar must be spent on direct care and less on administration.
Health care planning must be based on community health needs.
Health care decisions must be focused on outcomes-based research
to improve the quality of care, to reduce inappropriate utilization,
and to improve health status.
Legislation
February 22, 2007:
Testimony in Support
of 2008-2009 Biennial Budget
January 24, 2007: Testimony
in Support of LD 215-Supplemental Budget
Reports
Maine Hospital Association Survey
of Free Care Policies March 20, 2007
MaineCare Hospital
Reimbursement
Cost of Caring
Maine's
Medicare Payment Shortfall
Maine's
Medicaid Payment Shortfall
Opinion Editorials
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