COD E R E D

Other Health Insurance Reforms/Initiatives in the StateColorado Benefits Management System (CBMS) — Colorado is the first state in the nation todevelop and implement a fully integrated eligibility system for cash assistance and benefits. 344The system became operational in Fall 2004, however, it has been plagued with problems andthe legislature has had to appropriate additional funds to address the problems that haveresulted.MaineState DemographicsThe population of Maine in 2003 was 1,272,010. 345 The percent uninsured was 11 percent. 346Fifteen percent of the population had incomes below the federal poverty level. 347Medicaid (MaineCare) Eligibility• Pregnant women: 200 percent FPL.• Infants: 200 percent FPL.• Children ages 1-19: 150 percent FPL.• SCHIP Children (CubCare): 200 percent FPL.• Parents: 150 percent FPL.• Single adults (non-categoricals): 100 percent FPL, scheduled to be expanded to 125percent FPL three months after Dirigo Health begins enrollment (see below).• Parents of MaineCare eligible children: 150 percent FPL, scheduled to be expanded to200 percent FPL three months after DirigoHealth begins enrollment (see below). 348MaineCare Financing MethodTotal Medicaid spending in Maine in FY 2003 was $1.8 billion. 349 Maine’s federal matching ratefor Medicaid was 69 percent for fiscal year 2004, and will be 65 percent and 63 percent for FY2005 and 2006, respectively. 350 Maine’s state Medicaid expenditures accounted for 20 percentof state general fund expenditures in 2003. 351The average Medicaid spending per enrollee in FY 2000 was $6,240. This varied from anaverage of $2,817 spent on each child to an average of $14,645 spent per enrollee in the blindand disabled group. 352 The estimate of Maine’s payments per enrollee for children is muchhigher than expected. This is largely due to much higher than average amounts of paymentsreported under “other services” for this group. It is unlikely that all of the payments attributed tochildren actually should be attributed to children, or at least to those children currently enrolledin the program.MaineCare BenefitsMaineCare offers inpatient and outpatient hospital services, public and mental health clinics,federally qualified health centers, religious non-medical health care institution and practitionerservices, and rural health clinics. The following are types of benefits offered:• Dental services, dentures, eyeglasses and services for speech, hearing and languagedisorders.• Laboratory and X-ray services.C-25