State lawmakers passed a bill that would provide 180,000 uninsured people access to medical coverage in one of the nation's most comprehensive health insurance plans.
The House tally was 105-38 and the Senate approved the measure 25-8, allowing the state to start organizing the program in 90 days. The plan is expected to go into effect next year.
First-year Democratic Gov. John Baldacci, who campaigned on the promise of universal health care, was expected to sign the bill next week, spokesman Lee Umphrey said.
The plan would create a quasi-public agency to help people secure medical coverage through private insurers. Under the plan, all Maine residents who cannot otherwise afford health care insurance would have access to low cost coverage by 2009.
Participants would be charged subsidized premiums that would vary according to their ability to pay and the amount of coverage purchased.
Funding would come from a patchwork of sources, including a tax on insurance companies and $80 million the state expects to save each year by eliminating unreimbursed medical costs run up by uninsured people.
But critics portrayed the program as untried and doomed to failure.
"This bill is illusion and promise not fulfilled," Assistant House Minority Leader David Bowles, a Republican, said before the final vote. "This bill is not the right thing."
Arthur Levin, director of the New York-based Center for Medical Consumers, said Maine was ahead of other states in its efforts to reform health care.
He said without federal help, "it falls to the states to pick up the pieces."
Maine's move toward universal coverage is unusual in a year when most states are simply trying to maintain the coverage they have, said Donna Folkemer of the National Conference of State Legislatures.
The legislation aims to hold down medical care costs with voluntary price caps for providers, hospitals and insurers, and a limit on non-hospital outpatient procedures.
Maine also has a program called Maine Rx to use its buying power to force drug companies to offer bulk discounts on prescription drugs for the elderly, the working poor and others who have trouble paying for their medicine. Maine Rx was upheld by the U.S. Supreme Court last month.
The U.S. Senate has scheduled debate next week on legislation providing prescription drug coverage for millions of Medicare recipients, and House Republicans have proposed a similar bill. If approved, the changes would be the most far-reaching to the program since its creation in 1965.