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Leading the Way? Maine's Initial Experience in Expanding Coverage Through Dirigo Health Reforms

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In 2003, Maine adopted the Dirigo Health Reform Act, which aimed to make affordable health care coverage available to every Maine citizen by 2009, slow the growth of health care costs and improve the quality of care. As part of the reform effort, Maine developed two coverage options for its residents: DirigoChoiceTM, a subsidized insurance product, and a Medicaid eligibility expansion for low-income parents of dependent children. At the time the legislation passed, Maine was the first state since the early 1990s to enact comprehensive health care reform legislation and to set a goal of providing affordable health insurance coverage to everyone in the state.
In this evaluation of Maine's health reform plan, researchers examine interim indicators of progress after two years of program implementation. Since enacting comprehensive health care reform in 2003, the effort has helped expand coverage for low- and moderate-income individuals. Yet by late 2006, the initiatives had enrolled less than 10 percent of previously uninsured residents.
Researchers identify both the successes and challenges of the program. They also consider how Maine's experiences could serve as a lesson for other states which are exploring initiatives to expand access and provide affordable insurance.