Insurance Law Far From Cure
01/31/2007
By Eileen McNamara, Boston Globe Columnist | January 31, 2007 Nine months has been time enough to give birth to a new state bureaucracy but not nearly long enough to deliver affordable healthcare to the uninsured in Massachusetts. The law -- passed with such fanfare last April in an attempt to bring reasonably priced, comprehensive healthcare to the approximately 500,000 people in Massachusetts who are uninsured -- is experiencing the labor pains critics long predicted. The Commonwealth Health Insurance Connector Authority is up and running with a 22-person staff earning an average salary of $111,000 a year, compensation sizably heftier than the wages of the uninsured facing monthly premiums for an individual of $380 for the most basic "affordable" plans being considered by the new quasi-independent state agency. That is almost twice what Mitt Romney predicted the plans would cost before he set off on his delusional bid for the presidency, touting universal healthcare as the capstone of his career. The law is to be funded through a combination of federal reimbursements, state funds, new assessments on businesses that do not provide health insurance, and a requirement that all residents buy health insurance or face financial penalties. The state will subsidize those who cannot afford to purchase insurance. The Connector Authority board itself acknowledged last week that proposed premiums are too high by asking insurers to resubmit their bids. But the board is no better able than insurers to answer the questions that have bogged down this so-called landmark reform from the outset. How will the state be able to keep down premiums when the price of healthcare keeps rising and the law provides no mechanism for cost containment? How will the state handle the tens of thousands of people who now have bare-bones health insurance that is unlikely to meet the board's minimum standards for "comprehensive coverage "? The board has until March to define those standards. By July 1, individuals must secure insurance that measures up or they will be subject to fines, a policy that is supposed to promote individual responsibility but that will end up penalizing the working poor. Now that the board has learned that an estimated 200,000 people in Massachusetts are underinsured, it is faced with some difficult choices: Reduce the minimum standards or demand that people who cannot afford it pay for better coverage. Insurance plans under the new law are supposed to provide "reasonably comprehensive coverage," a phrase the board sensibly has interpreted to include everything from preventive care to mental health services and prescription drug coverage. But those provisions do not come cheap, and the options for paying for them are limited and unappealing. Increase the out-of-pocket expenses of the insured? Cut back on the services ? The one solution not on the table is the one that is the most obvious: Increase the assessment on employers who do not provide health insurance for their workers. The law now requires only that employers of 50 or more people kick in $295 per worker per year for the state to help provide it. Just how paltry that amount is became clear when we learned that insurers expect individuals to pay $380 in premiums per month. It is a new day on Beacon Hill. There is a Democratic governor and a Democratic majority in the Legislature. They could start the legislative session acting like Democrats and acknowledge what lawmakers and a Republican governor refused to admit at that self-congratulatory bill signing ceremony at Faneuil Hall. Universal health insurance will be expensive, and the uninsured and the underinsured cannot be expected to bear a disproportionate burden. The Legislature owes one to the people. Earlier this month lawmakers blocked a ballot initiative that would have put the demand for real universal healthcare on the ballot next November. The least they can do now is go back and fix the faux universal healthcare law they saddled us with last year. Eileen McNamara is a Globe columnist.
|
