Maine Association of Health Plans Responds to Part 1 of Superintendent's Determination of Dirigo Savings

Media Statement

For the fourth year in a row, Maine’s Superintendent of Insurance has determined that reasonably supported savings are far less than those found by the Dirigo Health Agency Board. This year’s decision, released late Tuesday, finds reasonably supported savings of $48.7 million, an amount that is $15.9 million or 50% higher than last year’s savings. Regardless of the savings amount found or the ultimate Savings Offset Payment (SOP) determination, replacing the SOP process is in the best interest of Dirigo Health.

The Superintendent’s findings, like those of her predecessors, shows that the SOP assessment is a fundamentally flawed mechanism that needs to be replaced with a predictable funding source that is broad-based. This assessment undermines confidence in and support of the Dirigo Health program. Each year the DHA has found significantly different amounts of savings and each year these numbers have been substantially reduced after the Superintendent’s review. The process for determining savings is unreliable, expensive, and destabilizing for Dirigo because of the difficulty of accurately measuring savings.

We are concerned about the inclusion of a Medical Loss Ration category of savings. However, since Part II of the Superintendent’s decision, a statement of findings, is not due to be issued until September 30, it is premature to comment on the rationale behind her determinations at this time.

About the Maine Association of Health Plans
The MEAHP is a non-profit trade organization that represents the state’s four major health insurers – Aetna, Inc., Anthem Blue Cross and Blue Shield, CIGNA HealthCare of Maine, Inc. and Harvard Pilgrim Health Care. Collectively, the members provide health insurance coverage for roughly 680,000 Maine people.

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