An Act To Increase Access to Health Insurance Products Amend the amendment by inserting after the title the following: Amend the bill by striking out the title and substituting the following: Resolve, To Establish the Blue Ribbon Commission To Study Alternative Models for the Dirigo Health Progam' , Further amend the amendment in the first paragraph after the title in the first line (page 1, line in amendment) by striking out the following: Amend" and inserting in its place the following: 'Further amend Further amend the amendment in the first paragraph after the title in the first 2 lines (page 1, lines 22 and 23 in amendment) by striking out the following: "enacting clause" and inserting in its place the following: 'title Further amend the amendment by striking out all of sections to 10 and inserting in their place the following: Sec. 1. Commission established. Resolved: That the Blue Ribbon Commission To Study Alternative Models for the Dirigo Health Program, referred to in this resolve as "the commission, is established; and be it further Page l-LR2927(10) SENATE AMENDMENT
Maine Legislature, Session 122, LD 1845
Committee Amendment CA_A-SA_B_S633 (Senate)
Committee: Appropriations and Financial Affairs

SENATE 
AMENDMENT "B" to COMMITTEE 
AMENDMENT 
"A" to H.P. 
1285, 
L.D. 
1845, Bill, 
"An Act To 
Increase Access to Health 
Insurance Products" 
Amend 
the 
amendment 
by 
inserting 
after 
the 
title 
the 
following: 
'Amend the bill by striking out the title and substituting 
the following: 
'Resolve, 
To 
Establish the 
Blue 
Ribbon 
Commission 
To 
Study 
Alternative Models for the Dirigo Health Progam' , 
Further amend the amendment in the first paragraph after the 
title in the first line 
(page 1, 
line 
in amendment) 
by 
striking out the following: 
"Amend" and inserting in its place 
the following: 'Further amend" 
Further amend the amendment in the first paragraph after the 
title in the first 2 lines (page 1, lines 22 and 23 in amendment) 
by striking out the following: "enacting clause" and inserting in 
its place the following: 'title' 
Further amend the amendment by striking out all of sections 
to 10 and inserting in their place the following: 
'Sec. 1. 
Commission established. 
Resolved: 
That 
the 
Blue 
Ribbon Commission To 
Study Alternative Models for the Dirigo 
Health Program, referred to in this resolve as "the commission," 
is established; and be it further 
Page l-LR2927(10) 
SENATE AMENDMENT 
SENATE AMENDMENT 
L.D. 1845 
.. !J, to COMMITTEE AMENDMENT "A" to H.P. 1285, 
Sec. 2. Commission membership. Resolved: 
That the commission 
consists of 11 members appointed as follows: 
1. 
Two members of the Senate appointed by the President of 
the 
Senate 
and 
members 
of 
the 
House 
of 
Representatives 
appointed by the Speaker of the House. 
At least one legislative 
member appointed must be a member of the Joint Standing Committee 
on Insurance and Financial Services and at least one legislative 
member appointed must be a member of the Joint Standing Committee 
on 
Appropriations 
and 
Financial 
Affairs. 
Legislative 
appointments under this subsection must be representative of the 
bipartisan interests of the Legislature; 
2. 
Two members appointed by the President of the Senate, 
one member representing interests of employers recommended by a 
statewide organization of businesses and employers and one member 
representing 
hospitals 
recommended 
by 
a 
statewide 
hospital 
association; 
3. 
Two members appointed by the Speaker of the House, one 
member representing health insurance carriers recommended by a 
statewide association of health plans and one member representing 
insurance producers authorized by the Superintendent of Insurance 
to sell health insurance products; and 
4. 
Three members 
appointed by the Governor, 
one member 
representing the Dirigo Health Board of Directors, one member who 
is an employer enrolled in the DirigoChoice program and 
one 
member representing consumers; and be it further 
Sec. 3. Chairs. Resolved: 
That the first-named Senate member 
is the Senate chair of the commission and the first-named House 
of Representatives member is the House chair of the commission; 
and be it further 
Sec. 4. Appointments; convening of commission. Resolved: 
That 
all appointments must be made no later than 30 days following the 
effective date of this resolve. 
The appointing authorities shall 
notify the Executive Director of the Legislative Council once all 
appointments 
have 
been 
completed. 
Wi thin 
days 
after 
appointment 
of 
all 
members, 
the 
Executive 
Director 
of 
the 
Legislative Council shall call and convene the first meeting of 
the commission, which must be no later than August 15th; and be 
it further 
Sec. 5. Duties. Resolved: 
That the commission shall study 
alternative models for the Dirigo Health Program in comparison to 
the current operations of the program, including the formation of 
a 
self-administered 
plan, 
the 
establishment 
of 
a 
nonprofit 
SENATE AMENDMENT 
SENATE AMENDMENT 
L.D. 1845 
to COMMITTEE AMENDMENT "A" to H.P. 1285, 
entity, 
the 
use 
of 
a 
voucher 
system 
and 
other 
models 
for 
providing access to health care benefits under the program. 
In 
conducting this study, the commission shall for each model: 
1. 
Develop a timeline and enrollment goals to reduce and 
eliminate the number of uninsured residents in this State under 
that model and test the model's viability to meet the timeline 
and enrollment goals; 
2. 
Develop projections for the expected funding needs for 
subsidies annually and sources of funding for subsidies; 
3. 
Estimate anticipated program costs, 
including premium 
rates and other costs to program enrollees; 
4. 
Develop a projected budget for administrative costs; 
5. 
Evaluate the potential liability of the State, Dirigo 
Health, health care providers and enrollees in the program in the 
event of an insolvency; 
6. 
Compare the model to similar models used in the private 
sector 
and 
evaluate its financial 
structure 
for 
safety 
and 
soundness; 
7. 
Evaluate 
the 
potential effect of 
the 
model 
on 
the 
private market for health insurance in the State; and 
8. 
Evaluate the need for additional regulation of the model 
to ensure consumer protection; and be it further 
Sec. 6. Staff assistance. Resolved: 
That, upon approval of the 
Legislative Council, the Office of Policy and Legal Analysis and 
the Office of Fiscal and Program Review shall provide necessary 
staffing services to the commission; and be it further 
Sec. 7. Compensation. Resolved: 
That legislative members of 
the commission are entitled to receive the legislative per diem, 
as defined in the Maine Revised Statutes, Title 3, section 2, and 
reimbursement for travel and other necessary expenses related to 
their 
attendance 
at 
authorized 
meetings 
of 
the 
commission. 
Public members not otherwise compensated by their employers or 
other entities that 
they 
represent 
are 
entitled to 
receive 
reimbursement of necessary expenses and, upon a demonstration of 
financial hardship, a per diem equal to the legislative per diem 
for their attendance at authorized meetings of the commission; 
and be it further 
SENATE AMENDMENT 
" .• ~. 
SENATE AMENDMENT 
.. B.. to COMMITTEE AMENDMENT "A" to H. P . 
L.D. 1845 
1285, 
Sec. 8. Report. Resolved: 
That, 
no later than November 
L 
2006, 
the commission shall submit a 
report that includes its 
findings 
and recommendations, 
including suggested legislation, 
for 
presentation 
to 
the 
joint 
standing 
committee 
of 
the 
Legislature 
having 
jurisdiction over 
insurance 
and 
financial 
services matters and the Legislative Council. 
The commission is 
authorized to introduce legislation related to its report to the 
submission of its report; and be it further 
Sec. 9. Budget. Resolved: 
That, the chairs of the commission, 
wi th assistance from the commission staff, shall administer the 
commission's budget. Wi thin 10 days after its first meeting, the 
commission shall present a work plan and proposed budget to the 
Legislative Council for its approval. 
The commission may not 
incur expenses that would result in the commission's exceeding 
its approved budget. 
Upon 
request 
from 
the 
commission, 
the 
Executive Director of the Legislative Council 
shall promptly 
provide the commission chairs and staff with 
a status report on 
the 
commission's 
budget, 
expenditures 
incurred 
and 
paid 
and 
available funds; and be it further 
Sec. 10. Receipt of outside funds authorized. Resolved: 
That the 
commission may seek outside funds to fund costs of the commission 
other than authorized per 
diem 
and 
expenses 
of 
the 
members 
authorized by section 7. 
Contributions to support the work of 
the 
commission may not be accepted from 
any party having 
a 
pecuniary or other vested interest in the outcome of the matters 
being studied. 
Any person, other than a state agency, desiring 
to make a financial or in-kind contribution must certify to the 
Legislative Council that it has 
no pecuniary or other vested 
interest in the outcome of the study. 
The certification must be 
made in the manner prescribed by the Legislative Council. 
All 
contributions 
are 
subject 
to 
approval 
by 
the 
Legislative 
Council. 
All funds accepted must be forwarded to the Executive 
Director of the Legislative Council along with an accounting 
record that includes the amount of the funds, the date the funds 
were received, from whom the funds were received and the purpose 
of and any limitation on the use of the funds. 
The Executive 
Director of the Legislative Council shall administer any funds 
received by the commission; and be it further 
Sec. 11. 
Appropriations and allocations. Resolved: 
following appropriations and allocations are made. 
That 
the 
SENATE AMENDMENT 
~'lO. 
~. 
SENATE AMENDMENT "&' to COMMITTEE AMENDMENT "A" to H.P. 1285, 
L.D. 1845 
LEGISLATURE 
Study Commissions - Funding 
0444 
of $500 in fiscal year 
is received to support 
To 
Study Alternative 
lni tiati ve: 
Provides a base allocation 
2006-07 in the event that outside funding 
the work 
of the Blue 
Ribbon Commission 
Models for the Dirigo Health Program. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
SUMMARY 
2005-06 
$0 
$0 
2006-07 
$500 
$500' 
This amendment removes all of the provisions in the majority 
report and turns the bill into a resolve requiring the creation 
of the Blue Ribbon Commission To Study Alternative Models for the 
Dirigo Health Program. 
The amendment requires the commission to 
study 
alternative 
models, 
including 
the 
formation 
of 
a 
self-administered plan, the establishment of a nonprofit entity, 
the use of a voucher system and other models. 
The commission is 
composed of 11 members, including 4 Legislators, a representative 
of the Dirigo Health Board of Directors and members representing 
the interests of employers, health insurance carriers, hospitals, 
insurance producers and consumers. 
The amendment requires the 
commission to report to the First Regular Session of the l23rd 
Legislature 
and 
also 
authorizes 
the 
commission 
to 
introduce 
recommended legislation. 
This amendment adds an appropriations 
and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
SPONSORED BY, tJt:a~ };u11o---
(Senator SNOWE-MELLO) 
COUNTY: 
Androscoggin 
SENATE AMENDMENT 
Approved: 04/26/06 ;tJi?'ae. 
LD 1845 
LR 2927(10) 
An Act To Increase Access to Health Insurance Products 
Fiscal Note for Senate Amendment ,S, to Committee Amendment 'A" 
Sponsor: Sen. Snowe-Mello 
Fiscal Note Required: Yes 
Fiscal Note 
Current Costs - Legislative Study 
2005-06 
2006-07 
Projections 
2007-08 
Projections 
2008-09 
Appropriations/Allocations 
Other Special Revenue Funds 
Legislative Study 
$0 
$500 
$0 
The projected costs to fund the general operating expenses of the Blue Ribbon Commission to Study 
Alternative Models for the Dirigo Health Program are $2,850 in fiscal year 2006-07. The 
Legislature's budget includes $20,000 in fiscal year 2006-07 for legislative studies. Whether that 
amount is sufficient to fund all studies will depend on the number of studies authorized by the 
Legislative Council and the Legislature. There is also a base allocation of $500 in fiscal year 2006-
in the event that outside funding is received to support the work of the commission. 
Fiscal Detail and Notes 
By eliminating the provisions in the committee amendment this amendment eliminates the potential costs to the 
General Fund but adds the costs of the legislative study. 
LR2927(1O) - Fiscal Note - Page 1 of 1 
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