Maine Politics

From the Piscataqua to the St. John

Tuesday, February 15, 2005

More on the Cost of Care

From a BDN article today on mental health coverage:
State officials say the cash-strapped MaineCare program would save about a million dollars a year if private insurance companies paid for mental health services as mandated by the Maine Legislature in 2003. But at a public hearing Monday in Augusta, insurers and the business community argued that forcing the issue will drive up the price of health coverage for all Mainers and end up costing the state more than it saves [...]

[Portland Representative Ben] Dudley pointed out that insurers already have raised premiums over the past two years, partly in anticipation of paying more for mental health services. "The question is, has the industry been benefiting without the state getting the intended savings?" he said.

Why are insurance companies currently allowed to disregard a law already passed by the legislature? If I get pulled over for speeding, I doubt the officer would be agreeable if warned him or her not the "force the issue" by giving me a ticket. The fact that insurers have already raised their rates while not paying for the services the state has mandated is reprehensible.

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If MaineCare is doing things right, as I'm sure they are, their computer should be denying claims for services to beneficiaries who have other insurance coverage, and telling the provider to bill the other insurance first. If the other insurance denies the claim and the provider can produce evidence to that effect then MaineCare will have to pay for the service if it is covered by MaineCare. I agree that the state should find out what is going on. Don't forget, however, that Maine's insurance mandate applies only to insurance that is not exempted by the federal ERISA law. Most large employers are exempted by ERISA because they, not the insurance company which is just an administrator in these cases, are funding the risk of employee health insurance.

2/17/2005 07:58:00 AM


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10/06/2005 03:19:00 PM



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