The Maine Bureau of Insurance recently issued its long awaited report Health Insurance Coverage for Maine’s Direct Care Workers (pdf) and recommends the development of a pilot program to cover a segment of the direct-care workforce. The report was the work of a working group convened over the summer by the Superintendent of Insurance at the direction of the Insurance and Financial Services Committee. Several direct care workers, providers and advocates participated in the group.
The recommended pilot program that “would allow several large home- and community-based direct-care service providers to receive an enhanced State reimbursement directed toward paying for coverage within DirigoChoice.” Specifically:
- The Legislature could direct enhanced General Fund or MaineCare reimbursements specifically to pay solely for coverage through DirigoChoice. Participating employers would be required to demonstrate that the enhanced payments were used in this manner.
- The Dirigo Health Agency would open large group enrollment strictly to the home- and community-based direct-care service providers receiving the enhanced reimbursements.
- Home- and community-based direct-care providers with 50 or more DCWs eligible for coverage could apply to participate in the pilot. Participation would be voluntary. The maximum number of participating firms would be based on the amount of available funding.
- The pilot would provide an opportunity to examine the extent to which employees take up coverage, the level of benefits and premium best suited to the DCW workforce, and the impact providing coverage has on workforce retention.
“Given the state’s economic situation, a universal health insurance plan for the state’s entire direct-care workforce is not feasible. However, starting with a pilot project may be the best strategy under the current climate to move things forward,” said Allison Lee, National Campaign Manager for HCHCW. The report concludes that “although there are no easy solutions given budgetary constraints and challenges, it is certain that absent effective interventions to provide health coverage to DCWs, the need for DCWs in Maine will outpace the supply.” The report now goes to the State Legislature.
Allison Lee
National Campaign Manager
HCHCW
alee@phinational.org
Helen has been an effective and consistent leader in Maine. There is no better investment in our economy then the direct care workforce. They must have health care coverage.
No one would argue that everyone should be offered health care benefits, and a quick and easy solution would be to put the costs into the formula of the reimbursements rates from the state. With all the states running deficit budgets, this will not happen in the near future.