An Act To Implement the Recommendations of the Health Care System and Health Security Board
Maine Legislature, Session 121, LD 1540
Committee: Insurance and Financial Services
Amends: 5 MRSA §12004-G, 24-A MRSA §69

Legislative Document 
No. 1540 
H.P.1129 
House of Representatives, April 10, 2003 
An Act To Implement the Recommendations of the Health Care 
System and Health Security Board 
Reported by Representative O'NEIL of Saco for the Health Care System and Health 
Security Board pursuant to Public Law 2001, c. 439, Pt. ZZZ, section l. 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed under Joint Rule 218. 
Printed on recycled paper 
Ir/~'frl·mc~ 
MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 5 MRSA §12004-G, sub-§14-D is enacted to read: 
l.4-D. 
Health 
Security 
Health 
Security 
~ 
Expenses 
Only 
24-A MRSA 
§69Q3 
Sec. 2. 24-A MRSA c. 87 is enacted to read: 
CHAPTER 87 
MAIllE SINGLE-PAYOR HEALTH CARE PLAN 
§690l.. 
Definitions 
As 
used 
in this chapter, 
unless 
the 
context otherwise 
indicates, the following terms have the following meanings. 
1.. 
Board. 
"Board" 
means 
the Health Security Board as 
established in Title 5, section 12004-G, subsection 14-D. 
2. 
Pl.an. 
"Plan" means the Maine Single-payor Health Care 
Plan. 
3. 
Plan enrollee. 
"Plan enrollee" means a person enrolled 
in the plan. 
4. 
Provider. 
"Provider" means any person, organization, 
corporation or association that provides health care services or 
products and is authorized or licensed to provide those services 
and products under the laws of this State. 
5. 
Resident. 
"Resident" means a person who resides within 
the State. 
§6902. 
Maine Singl.e-p~r Health Care Plan established 
l.. 
Plan 
established. 
There 
is 
established 
the 
Maine 
Single-payor Health Care Plan to provide health care coverage to 
all residents 
through 
a 
plan that emphasizes quality, 
cost 
containment. choice of provider and access to comprehensive and 
preventive care. 
2. 
Igplementation and gperation of plan. Coverage under the 
plan must be available to residents beginning January L 
2005. 
Before the plan begins offering coverage, the board must develop 
recommendations for the implementation and administration of the 
plan and the Legislature must approve the recommendations in 
accordance with section 6903, subsections 2 and 3. 
§6903. 
Health Security Board 
1. 
Board ..... oorship. 
The board consists of 19 members as 
.follows: 
At 
The Commissioner of Human Services or the commissioner's 
designee: 
B. 
The Executive Director of the State Employee Health 
Commission or the executive director's designee: 
C. 
The State Tax Assessor or the assessor's designee; 
Dt 
The Senate chair of the joint standing committee of the 
Legislature 
having 
jurisdiction 
over 
health 
insurance 
matters; 
Et 
The House chair of the joint standing committee of the 
Legislature 
having 
jurisdiction 
over 
health 
insurance 
matters: 
F t A representative of each of the following, appointed by 
the Governor and confirmed by the Legislature: 
(1) 
A statewide organization that advocates universal 
health care: 
(2) 
A statewide organization that represents senior 
citizens in this State; 
(3) 
A statewide organization that defends the rights 
of children; 
(4) 
An statewide organization that represents health 
insurers and health maintenance organizations; 
( 5) 
A statewide labor organization; 
( 6) 
Health care economists; 
(7) 
A statewide organization of physicians; 
(8) 
A statewide organization of nurses: and 
(9} 
A ~tat~wid~ organizatiQn of hQ~pital~; 
G. 
Two representatives of the business community, appointed 
by the Governor and cQnfirmed by the Legislature, including: 
(1) 
A person representing the self-employed: and 
(2) 
A person representing businesses with 50 or fewer 
employees: and 
H. Three members of the public appointed by the Governor and 
confirmed by the Legislature. 
2. 
Development of 
implementation 
and administration of 
plan. 
The 
board 
shall 
develop 
recommendations 
for 
the 
implementation and administration of the plan. At a minimum, the 
board's recommendations must address the following; 
A. 
The 
organizational 
and 
governance 
structure for 
the 
oversight and administration of the plan: 
B. The coverage available to plan enrollees, including the 
benefit design or designs and any cost-sharing required from 
plan enrollees: 
C. The requirements for eligibility of plan enrollees; 
D. The development of a global budget, including the use of 
a 
certificate of need process or other methods of cost 
containment: 
E. 
The 
method 
for 
setting 
reimbursement 
rates 
for 
participating providers; 
F. The transition to a single-payor health care system and 
the coordination needed with federal and state programs that 
provide health care coverage; and 
G. 
The method and sources for financing the plan. 
3. Approval of implementation and administration of plan. 
The board shall submit a report, along with its recommendations 
and any necessary legislation, to the joint standing committee of 
the Legislature having jurisdiction over health insurance matters 
no later than January 1. 2004. The joint standing committee may 
report out legislation to the Second Regular Session of the 121st 
Legislature 
approving 
the 
board's 
implementation 
and 
administration of the plan and affirming the provisions of this 
chapter. 
SUMMARY 
This bill implements the recommendations of the Health Care 
System and Health Security Board to establish a 
single-payor 
health plan for 
the State. 
The bill establishes 
the 
Maine 
Single-payor Health Care Plan and requires that the plan begin 
offering coverage on January 1, 2005. 
The bill also establishes 
the Health Security Board to develop recommendations for the 
implementation and administration of the single-payor plan. Under 
the bill, the implementation plan and any necessary legislation 
must be approved by the Legislature before the single-payor plan 
begins offering coverage.