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As Health Plan Falters, Maine Explores Changes
ORTLAND, Me., April 23 — When Maine became the first state in years to enact a law intended to provide universal health care, one of its goals was to cover the estimated 130,000 residents who had no insurance by 2009, starting with 31,000 of them by the end of 2005, the program’s first year.

...So far, it has not come close to that goal. Only 18,800 people have signed up for the state’s coverage and many of them already had insurance.

“I think when we first started, in terms of making estimates, we really were kind of groping in the dark,” said Gov. John E. Baldacci, who this month proposed a host of adjustments.

... And there is John Henderson, 42, of Auburn, who enrolled in DirigoChoice in 2006 for about $90 a month while working at an L. L. Bean warehouse, a job he kept to 20 hours a week so his income would qualify him for such a low rate.

But he dropped the plan this year when rates increased by 13.4 percent on average. Mr. Henderson, who has diabetes and is currently jobless, said he had stopped once-regular doctor’s appointments and some medications that “I have just no hope of affording.”

Ms. Schneider’s group is suing the state insurance commissioner for approving the rate increase.

An Anthem spokesman, Mark Ishkanian, said the increase was necessary because medical claims of DirigoChoice customers were “substantially higher” than anticipated, about double those of non-Dirigo plans. One reason for the higher expense was “pent-up demand” by enrollees who had been deferring visits to doctors while they were uninsured, Mr. Ishkanian said. Another was the richness of the coverage, which enrollees used for treating long-held conditions or mental illness, he said.

Ms. Riley said the state was surprised that more than half of DirigoChoice enrollees qualified for the highest subsidy, 80 percent, which meant the program has been more expensive for the state.

She said Maine also expected more small businesses to enroll in DirigoChoice. But many businesses found that the program requirements of enrolling 75 percent of a firm’s employees and paying 60 percent of the cost were too expensive.

“If they weren’t able to afford insurance before, they’re unlikely to be able to afford Dirigo,” said Kristine Ossenfort, senior governmental affairs specialist of the Maine State Chamber of Commerce.....