Maine Association of Health Plans Responds to Part 2 of Superintendent's Determination of Dirigo Savings

Maine’s Superintendent of Insurance, Mila Kofman, has issued Part II of her Determination of Dirigo Savings detailing the complete statement of findings of fact supporting her decision. Although it is obvious that the Superintendent and her consultants put in a significant amount of hard work in crafting it, the Decision demonstrates strongly why the process governing the establishment of the Savings Offset Payment is fatally flawed.

After the elaborate and expensive analysis offered by Dirigo, the Superintendent, and the interveners (ourselves included), the determination indicates a range of possible savings due to Dirigo from over $400 million to $-80 million (that’s right, costing $80 million). This range of possible savings is so great that it proves how far removed this process is from reality. Regardless of the savings amount found or the ultimate Savings Offset Payment determination, replacing the SOP process is in the best interest of Dirigo Health, and all Mainers.

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.

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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