MAINE: Defense of the Dirigo Health

In 2003, Maine was among five states with the highest health insurance premium increases in the nation. Led by Gov. John Baldacci, Maine moved to solve the crisis by enacting the landmark Dirigo Health Reform Act. The legislation created Dirigo Health with the explicit goal of providing every man, woman and child in the state with access to high quality, affordable health care coverage. Cornerstone of the plan is Dirigo Choice, a public-private partnership that provides low-cost, comprehensive coverage with a sliding scale of premium rates based on income.

The Situation

The Heritage Foundation and the National Taxpayers Union led by Grover Norquise set up offices in Maine to fight this “socialist” health plan.

With strong support from out-of-state insurance companies that could no longer compete, they set their sights on killing Dirigo in Maine's 2005 legislative session.

They rolled out a three-pronged attack.

Republican proposals for the first of three legislative bills would cut state health expenditures, including Medicaid funding, to levels so low they would starve current financing for Dirigo Health.

Proposals for a second bill set out to block future funding for expansion of Dirigo Health coverage.

Still a third bill would accomplish the out-of-state insurers' objectives by dismantling Maine's health insurance consumer protections.

Passage of either of the first two Republican proposals would have crippled Dirigo Health. Passage of the third bill would kill it.

That's when Maine AFL-CIO President Eddie Gorham called America's Agenda for help.

"We need a campaign and a media voice to counter the fear and distortions about Dirigo that The Heritage Foundation and Grover Norquist are spreading around Maine."

The conservative media barrage was taking a toll. Approval ratings for Gov. Baldacci had fallen into negative territory. Democrats held slim majorities in both houses of the legislature and moderates were getting nervous. Support for Dirigo was wavering in the face of the right-wing assault.

Strategy

America's Agenda met with legislative and labor leaders, church representatives and health care consumer advocates. The core challenge of the campaign would be to clarify the issues at stake for Mainers and to mobilize their support within the six weeks remaining in the legislative session.

"Mainers for Health Care" welcomed the Diocese of Portland and the Maine Council of Churches to its swelling ranks. As the campaign accelerated, they were joined by professional, progressive and community organizations from around the state. Rallies and press conferences and standing-only crowds at legislative committee hearings earned positive media coverage.

Sensing slippage in their support, opponents called a press conference to make their case against future funding for Dirigo expansion. The "Mainers for Health Care" intervened with a quick response mobilization. Their message dominated the evening news.

America's Agenda produced radio spots and newspaper ads targeted to religious and mainstream audiences and challenged conservatives for support of their own core constituencies.

The campaign tracked all three Dirigo Health bills through the legislative process. America's Agenda drafted e-mail communications updates for workers before each crucial vote. The national and state AFL-CIO sent them to tens of thousands of Maine union members, who in turn e-mailed them to their state legislators. Having never received such a volume of constituent correspondence, Maine legislators were overwhelmed.

The Result

Ultimately, the campaign secured the votes of wavering moderates. An agreement was reached on current health care funding and for future funding. The Dirigo-killing bill was itself killed in committee.

The 2005 legislative victories were historic milestones for Dirigo Health. Dirigo's goal is to offer coverage to all of Maine's residents by 2009. The program is the first effort by a state to offer universal coverage to its residents. In addition to better care, cost containment provisions are paying off. Mainers no longer are saddled with some of the highest health insurance premium increases in the country. Instead, savings from the program in 2006 were $78.6 million, a great boon for consumers.

"The Governor and the legislative leadership are very appreciative of what America's Agenda has done for Maine. So are we. We could not have won these victories without the support of America's Agenda."

--Ned McCann, Secretary-Treasurer, Maine AFL-CIO