Today the Connector Board held their third and last public hearing on draft regulations on “minimum creditable coverage” (MCC), affordability, and CommCare premiums at Gardner Auditorium in the State House. Taking testimony were Connector Executive Director Jon Kingsdale, Board Chair Leslie Kirwin, Board members Celia Wcislo, Chip Joffe-Halpern, Louis Malzone, and Rick Lord, and Jamie Katz, General Counsel. More than 160 people listened to presentations from community groups, employers, advocates, hospitals, and consumers.
Philip Edmundson, Affordable Care Today!! Coalition Chair opened up a series of ACT!! panels with an overview of issues on affordability, prescription drugs, life-time caps, and cost-sharing.
Speakers from the National Alliance on Mental Illness of Massachusetts and the Mayor’s Helpline at the Boston Public Health Commission thanked the Connector for including prescription drugs in minimum creditable coverage, emphasizing the importance of access to drugs for basic health care. Dr. Stephen Soumerai added a research perspective on smart ways of designing drug coverage that promotes effective use.
They were opposed by several employer groups that urged the Board to remove the requirement that MCC plans include prescription coverage. The Massachusetts Association of Health Plans also opposed the drug requirement. The employer groups also supported the Connector’s aceptance of High Deductible Health Plans. John McDonough of HCFA testified that exempting these plans from MCC standards could harm health reform.
The Massachusetts Medical Society and AIDS Action Committee spoke in favor of setting at least a $1 million minimum for lifetime caps on plans. The proposed regulations do not restrict lifetime benefit caps. One parent shared a story of her child who was born with a congenital heart disease and has already reached over $1 million in treatment costs. Without a reasonable lifetime cap, HIV patients undergoing extremely costly drug therapy and procedures will also risk using up their coverage.
The topic of controlling cost and preserving affordable plans brought out compelling consumer stories as well as an informative debate on the issue. Single payer groups such as MassCare, and Physicians for a National Health Program spoke against high deductible plans and bureaucratic inefficiencies of our current system. The American Cancer Society, Greater Boston Interfaith Organization, and Massachusetts Hospital Association, speaking on behalf of ACT!!, stressed that high deductibles inhibit use of medical care and that out of pocket maximums should include all co-pays and medical expenses.
The AARP and Health Law Advocates asserted the need to exempt from the mandate penalties families faced with premiums that exceed 10% of their income, and asked for a 500%-600% affordability income band for individuals.
GBIO, Mass Law Reform Institute, and a representative from the Children’s Health Access Coalition lauded the Connector for the family premium cap, which waive premiums for children’s coverage for parents with Commonwealth Care. While people under 100-150% fpl levels do not pay premiums, the groups would like to see this population shift to plan type 1, where dental coverage is available.
Artist groups highlighted the importance of using adjusted gross income as standards for self-employed people.
The Connector Board in turn expressed their appreciation for all the speakers and the effort put forth in the testimonies. The Board will vote on these regulations on June 5, at 3:00 pm, at the next board meeting at One Ashburton Place, 21st Floor, Boston.