UHCEF Article of Interest

=====================================================
Jack Dew, Berkshire Eagle Staff
Berkshire Eagle
Friday, September 29

PITTSFIELD — Groundbreaking and historic. Deeply flawed and inadequate.

The new health insurance law that is slowly taking shape in Massachusetts is both, according to a panel of experts and legislators that met last night in Pittsfield.

The law is perhaps best understood as a framework to offer health insurance to most of the state’s uninsured. It requires every resident to have adequate health coverage by July 2007, but it did not create the plans in which people can enroll, nor did it allocate the funds to pay for those plans.

A new state authority, the Commonwealth Health Insurance Connector, will oversee health plans offered by the state’s private insurance companies. People under the federal poverty line will qualify for free insurance, and those making up to 300 percent of the poverty line will pay reduced premiums.

While the premiums have been set, the plans themselves don’t yet exist, and a raft of details are unresolved. Will there be enough money to fund the subsidies? Will the uninsured be able to afford the plans? Will the state penalize those who don’t have coverage?

“It’s a good bill and an important starting point,” but still a work in progress, said state Rep. Denis Guyer, D-Dalton. “It can be amended, changed, tweaked. Sections can be taken out. … We know it is not the end. But it is a historic first step.”

By all accounts, the state’s health plan is an innovative way to extend coverage. It can penalize people who don’t obtain insurance by taking away their state income tax exemption. It can also punish employers with 10 or more employees if they don’t offer an adequate health plan and don’t pay 20 percent of a family plan or 33 percent of an individual plan.

But it is precisely that innovation that worries Ben Day, executive director of Mass-Care, which is pushing for a single-payer health care system that would copy the plans used in Canada, England, France, Germany and most industrialized nations, in which the government pays the medical costs of the people.

“Every time you hear of an innovative health care solution is when it is time to run for the hills,” Day said. “Innovation is the one direction we can go that won’t work.”

He listed a series of failures in Maine, Tennessee, Minnesota and others, where the states tried to fix health insurance without going all the way to a single-payer system.

They failed, he said, because they did nothing to cut costs in health care and tried to address the needs of the uninsured without fixing the problem the insured are already facing of ever-increasing costs for adequate coverage.

Chip Joffe-Halpern, the executive director of North Adams-based Ecu-Health Care, holds one of the 10 seats on the Connector board, which is putting flesh on the skeleton of the health care law. Joffe-Halpern said the entire plan is still “a work in progress.”

When one of the roughly 35 people in the audience asked how the state will fund its share of insurance costs for the poor, Joffe-Halpern was blunt: “It is anticipated that we will face a crisis in funding, probably in 2009.”

Beginning Monday, some people will be able to enroll in the first of the new health insurance plans. Those enrollments are expected to accelerate in January, when more plans come on line, and reach full speed in July, when the mandate kicks in requiring insurance.

That, said state Rep. Christopher Speranzo, D-Pittsfield, will be when the state gets its first sense of whether the complicated new law will work.

All of the panelists agreed that a single-payer health care system is the ultimate goal, but there was a clear tension between the idealists who want single-payer health care and the pragmatists who feel the new law is a step down that road, helping government, the private sector, the people and the health care industry figure out how to work together.

Some worried that this first step will be a fatal one for poor patients, who will lose access to low-cost prescription drugs once they have insurance and will find the $20 or $30 co-pay too much.

Dr. Michael Kaplan of Lee, a local representative of Mass-Care, said that’s one reason we need single-payer health care now.

“It would no longer be health insurance. It would be health coverage,” he said. “It would take away all the barriers, not just some.”

» Health insurance highlights

* By July 2007, all residents must have some form of state-approved health insurance or face tax penalties.
* The state did not create a health insurance program. It is relying on private insurers to develop plans that will meet its criteria.
* A new state authority, the Commonwealth Health Insurance Connector, will vet health plans and decide whether they are adequate and affordable.
* The Connector will set rates for publicly subsidized health plans.
* Residents making less than $9,804 a year will receive free health insurance.
* Those making between $9,804 and $29,412 a year will pay between $18 a month and $106 a month for insurance, depending on income. The state will subsidize the rest of the premiums.
* Those already receiving adequate health insurance through work or government programs like Medicare do not need to change their plans.
=====================================================
Universal Health Care Education Fund, 8 Beacon St, Ste 26, Boston, MA 02108-3722
uhcef@aol.com | 617-723-7001 | 800-383-1973 | fax 617-723-7002

This entry was posted on Friday, September 29th, 2006
and is filed under News Articles. Both comments and pings are currently closed. -->