An Act To Ensure Affordable Health Care for Maine Families through Shared Responsibilities
Maine Legislature, Session 123, LD 1894
Committee: Insurance and Financial Services
Sponsors: BRAUTIGAM

Legislative Document 
No. 1894 
H.P.1326 
House of Representatives, May 4,2007 
An Act To Ensure Affordable Health Care for Maine Families 
through Shared Responsibilities 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative BRAUTIGAM of Falmouth. 
Printed on re(,;ycled paper 
7J'l~ m.7I/p£~ 
MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
CONCEPT DRAFT 
SUMMARY 
This bill is a concept draft pursuant to Joint Rule 208. 
This bill proposes to significantly expand health care coverage on the principle of 
shared responsibility. 
Under this bill, access to health care in Maine will continue to expand based on the 3-
tiered approach established by Dirigo Health in 2003. At the foundation, MaineCare will 
cover the most needy families and individuals and will reduce the strain of 
uncompensated care on the private market. DirigoChoice will provide a sliding scale 
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subsidy to cover those who do not qualify for MaineCare but who find standard insurance 
unaffordable. Distortions in the private insurance market will be corrected to reduce 
costs for consumers in the non group market. 
The major components of the bill are: 
IS 
1. Employer contribution. The bill requires that employers pay an assessment 
based on the employer's taxable payroll. Before making such payment, the employer may 
credit against the payment any sums paid by the employer toward employee nonpayroll 
benefits. Small employers, employers in financial hardship and employers in business for 
less than 2 years may be exempted from the employer contribution. The assessment must 
be used solely for the purpose of e~_pallJing access to health care through the Dirigo 
Health Program. 
2. Insurance carrier contribution. The bill requires each insurance carrier to 
achieve a minimum loss ratio, to be specified in this bill, across all its products. This 
minimum loss ratio must be calculated at the end of each calendar year and must reflect 
the aggregate of all health insurance products sold in Maine by that carrier. 
Any 
insurance carrier that does not achieve the minimum loss ratio must be assessed an 
amount equal to 112 of the difference between the carrier's actual loss ratio and the 
minimum loss ratio. The carrier may not pass through any portion of the assessment to 
individual policyholders or providers. 
This assessment must be used to provide 
reinsurance to reduce premiums in the nongroup health insurance market and in the 
DirigoChoice product. 
3. Hospital contribution. Under this bill, each hospital licensed to operate as a 
charity in the State must provide an amount of free charity care, to be determined in this 
bill. Any hospital that does not provide free care in the statutorily determined amount 
will be assessed an amount equal to the difference between the statutorily determined 
amount and the value of the free care actually provided by the hospital. The charity 
hospital may not pass this payment on to patients, providers or carriers. 
Any charity 
hospital in financial hardship may apply to the Department of Health and Human 
Services for a waiver of the assessment. A hospital is not in financial hardship if its most 
recent yearly operating margin exceeds a threshold to be determined in this bill, or if its 
unrestricted financial assets exceed a percentage of its net operating revenue to be 
determined in this bill. The assessment will be used solely for the purposes of expanding 
access to health care through the Dirigo Health Program. 
4. 
Individual contribution. 
The bill requires that persons earning above a 
statutorily determined income threshold ensure that they and their dependents are covered 
by a comprehensive health insurance policy by January 1,2008, except that for a person 
under 30 years of age, a qualifying health insurance policy is any policy approved by the 
Department of Professional and Financial Regulation, Bureau of Insurance. A person 
who does not maintain a qualifying health insurance policy for at least 10 months during 
the year may not be credited with the standard individual exemption in that person's next 
Maine income tax filing. 
The Department of Administrative and Financial Services, 
Bureau of Revenue Services will transfer the value of any increased tax collections as a 
result of this provision to the Dirigo Health Program. 
5. Application of assessments. The bill requires that funding from the employer, 
hospital and individual contribution sources be applied to achieve the goal of expanding 
access to health care by opening Dirigo Health up to 60,000 members by 2010. 
6. Cost containment. The bill establishes a cost containment commission, which is 
charged with the responsibility and authority of achieving savings of 2% in the cost of 
health care in the State. 
7. Rulemaking. The bill authorizes Dirigo Health, the Bureau of Insurance, the 
Bureau of Revenue Services or other authority established pursuant to this legislation to 
undertake rulemaking to enforce the provisions of this bill. The rules adopted pursuant to 
this authority are routine technical rules.