Bay State Embarks on Health Care Reform

Thu May 04, 2006 - Northeast Edition
David O. Hunt Jr.

Massachusetts has set into motion sweeping reforms for health insurance in the Bay State.

“What Massachusetts is doing, who they are covering, how they’re crafting it, especially the individual requirement, that’s all unique,” said Laura Tobler, a health policy analyst of the National Conference of State Legislatures.

Massachusetts Gov. Mitt Romney, a Republican, signed into law a wide-ranging health insurance reform measure on April 12.

Under the measure, every citizen who can afford health coverage will be required to secure it. Residents will be required to provide proof of insurance on state tax forms starting in 2008. The measure intends to cover 90 to 95 percent of the state’s estimated 500,000 uninsured residents over the next three years.

The measure effectively combines the non-group and small-group markets in Massachusetts in July 2007. An actuarial study of this action will be completed before the merger of these markets to assist private insurers. The insurance industry maintains a large presence here.

The measure also creates a Commonwealth Health Insurance Connector, linking individuals and small businesses with health insurance products. The connector provides for more portability of insurance as people move between jobs, and allows more than one employer to contribute to an employee’s health insurance premium. The connector will be operated under the authority of the Commonwealth of Massachusetts.

The package also allows health maintenance organizations (HMOs) to offer coverage linked to Health Savings Accounts, saving money for people who enroll in these plans.

In the health care policy arena, conservatives generally support greater individual responsibility, while liberals back employer-paid mandates.

The original measure — passed overwhelmingly by the Democrat-controlled Massachusetts legislature – provided a blend of both approaches. Individuals who are able to afford coverage were required to have it, while businesses not insuring their employees would have been required to pay an assessment to cover the state’s uninsured.

The measure originally created an assessment — with an annual fee of $295 per year — on employers with 11 or more employees who don’t currently provide health insurance.

Romney vetoed the assessment portion of the bill. He said the assessment was “not necessary to implement or finance health care reform.” House Speaker Salvatore DiMasi told the National Press Club that the House intends to “overwhelmingly” override the veto of the assessment this week.

“In reality, the veto of the assessment will probably be overridden,” said Bill Vernon, state director of the National Federation of Independent Business, whose group firmly supported Romney’s stance on the package.

“The issue was looked at inside and out, and powerful interests were all pushing for an advantage,” said Vernon. “It was quite a process.”

Phil Edmondson of Affordable Care Today said businesses, in part, agreed to the measure to cut down on the cost-shifting that currently goes into caring for the uninsured.

Reaction from the construction industry was more muted.

Glenn Kingsbury, executive director of the Boston Chapter of the National Electrical Contractors Association, whose members all carry health insurance, had hoped those companies that are not providing health insurance would have been charged a higher assessment for the state’s uninsured care pool.

John McDonough, a former legislator and executive director of Health Care for All suggested the measure is not perfect.

“The level of employer responsibility is minimal and does not come close to the cost borne by employers who do cover their workers.”

Romney said he ran as governor on a platform of reforming health insurance in Massachusetts. He said he saw the reform package as a springboard for health insurance changes in other states.

“This is a Democratic ideal, which is getting health care for everybody, but achieved in a Republican way, which is reforming the private marketplace and insisting on personal responsibility,” said Romney.

Some in the business community see Romney as a potential GOP presidential nominee. Romney’s father ran unsuccessfully as a Republican presidential nominee in 1968.

“If there are national implications and applicability, that would be wonderful,” Romney said. CEG