Passage of comprehensive health reform is an historic achievement, on a par with the establishment of Social Security and Medicare. But the real task of reforming America’s ailing health care system is just beginning.
Provisions to eliminate lifetime benefit caps and introduce tax credits for small businesses that provide health insurance start immediately. Others like the individual mandate and health insurance exchanges won’t take effect for another four years. That is a huge challenge confronting reformers.
In 2003, Maine created Dirigo Health, one of the most significant health reform initiatives by any state. Like the current national reform, several key Dirigo provisions took time to implement. Opponents used this transition to undermine program support and chip away at its scope and impact.
National reform advocates should heed Maine’s experience. While passing comprehensive legislation was a monumental accomplishment, maintaining its integrity may be an even greater challenge.
Maine is well-positioned to realize significant benefits from national reform. Since many of Maine’s consumer protections mirror provisions in the new federal law, opponents can no longer argue that Maine is at a competitive disadvantage with other states. Other provisions in the new federal law will complement Maine’s efforts to modernize our health data system and reform the way we pay for health care to address both quality and cost. Because we have already expanded MaineCare eligibility and created DirigoChoice, the state can more rapidly deploy federal funds to improve Mainers’ access to affordable coverage.
Maine is at the forefront of comprehensive health care reform. The landmark reforms Congress just enacted affirm Maine’s efforts and increase the likelihood they will flourish. But reformers at the state and national level must remain vigilant and continue to work together to deliver quality, affordable health care for all.