While the first BOI meeting was largely a round of introductions and a broad overview of the work ahead, at this last meeting BOI staff delved into the nitty-gritty of the Maine Insurance Code. The point of this exercise was to see if there was already an existing model/structure that would allow the Direct Care workforce to organize some kind of insurance purchasing pool or entity that could acquire coverage through the private markets (or form their own, independent insurance pool that essentially would act as an insurance company specifically for Maine’s direct-care workers (DCWs).
Staff presented the seven organizational structures for group purchasing permitted under Maine law. A lot of it was fairly technical, but the folks assembled at the BOI meeting were able to identify several models on which BOI staff will do more research and report back to the group. I believe these models included “Trustee Groups” and “Labor Union Groups” (and possibly “Small Group Health Plans”). Unfortunately, most of the seven permitted structures have specific rules that would make it difficult for DCWs to use them as models for organizing a purchasing group (for example: a) policies can’t be sold to individuals who are not directly employed by an employer, or b) the organization must be formed for purposes other than purchasing insurance and must be in existence for more than two years prior to initiating the purchase/provision of insurance, etc).
Learning more about these models may lead us to a permitted structure that holds special promise for DCWs. As a number of people have noted, however, it is not only a matter of organizing DCWs into a legally permissible purchasing group. A significant hurdle exists in identifying ways to make coverage economically feasible, regardless of the structure under which DCWs are organized. Under any circumstances, a little more information on these models will be instructive and will help us understand the regulatory environment to which we currently must conform. It may also help us understand how those regulations impede the provision of coverage to DCWs and thereby allow us to work with BOI andlegislators to alter that system so it better serves the needs of DCWs.
As it now stands, at the next BOI meeting (Monday, July 14th, 10-12 at BOI). Stay tuned.
Kurt Wise
Fiscal Policy Analyst
Maine Center for Economic Policy
kwise@mecep.org
