At the end of Reed Abelson’s otherwise solid piece in the August 5 New York Times on a new study showing that millions of uninsured Americans are not getting treatment for chronic diseases like diabetes and high blood pressure is an unjustified hit on Massachusetts health reform. A hit on the very law that has enabled hundreds of thousands of previously uninsured Bay State residents to get health insurance—and treatment for chronic diseases like diabetes and high blood pressure.
Citing Dr. Steffie Woolhandler, a physician and associate professor of medicine at Harvard, Abelson reports that health reform has cost much more than expected and that it has failed to achieve universal coverage because fewer people than expected are healthy. He also quotes Woolhandler, who has often questioned health reform, describing the law as an out and out disaster: “The state experiments have all failed because of cost,” she tells Abelson.
Wrong. First, no one who paid any attention to the negotiations and compromises that took place to pass Chapter 58 is surprised by the costs of the law. More people enrolling (the goal of health reform) means more additional expenditures—and more people covered with health insurance.
Second, as documented in a recent Urban Institute study published by Health Affairs, many of those who remain uninsured in Massachusetts are young and in excellent health.
Last, Chapter 58 has been a success. Approximately 355,000 previously uninsured Massachusetts residents now have health care. Other unquestionably positive findings from the Urban Institute include the following: In the first full year of implementation, the rate of uninsurance in Massachusetts fell by half from 13% in 2006 to 7% in 2007, with the biggest drop in uninsurance falling among low-income adults (24% to 13%). Low-income adults were more likely to get dental care thanks to health reform (49% in 2006 increased to 59% in 2007). Other bits of good news? Out of pocket medical costs dropped. Rates of medical debt dropped. Fewer respondents said that cost of care was a barrier to obtaining care.
And in a recent WBUR blog, our Commissioner of Public Health, John Auerbach, is touting the clear and growing links between increases in health insurance rates and increases in health outcomes.
This particular experiment has been successful—and continues to be.
Lindsey Tucker
What about those of us whose employers cancelled coverage? Small businesses pay no penalties (not that the $295 would prevent anyone from cancelling who had a mind to do so). My income is only slightly over Commonwealth Care guidelines…so I guess I am out of luck.
“This particular experiment has been successful—and continues to be.”
Experiment? I am part of an experiment? I don’t remember giving anyone permission to use me for experimental purposes. I am in a position that, under ordinary circumstances, I would go without coverage for a hopefully short period of time while I search for a job. However, I am forced to purchase something I really can’t afford while unemployed since I am part of this “experiment”.
PJ,
You’ve got it, we are all just “lab rats” to the folks at HCFA and other defenders of this lousy scheme.
Lindsey,
What’s a resident?
Thanks, Ron, for your support. I take it Lindsey Tucker has no interset in responding to feedback on her own article. Oh, that’s right, we are all just small parts of the “experiment” and what we think does not matter. Is Lindsey’s health coverage in jeopardy? Has she ever been told what she can afford by people who typically have incomes three times and beyond her own?
PJ,
Thank you for your comments! I am sorry that your employer cancelled coverage. If you are ineligible for Commonwealth Care, I recommend looking at the Connector’s website to see what private plans are available to you, (www.mahealthconnector.org). It is a common misconception that everyone is “forced” to purchase health insurance. The Connector has created an Affordability Schedule, indicating what amount of money folks can be asked to spend on health premiums under the Individual Mandate. If your income is just above the eligibility cut off for Commonwealth Care, it is possible that you are not mandated to purchase health insurance. For example, if you, as an individual, make $35,000, you are expected to pay $165/month. If there is no plan available at that price, you do not have to purchase health insurance under the individual mandate. There is also a waiver system set up for those who still cannot afford coverage. The Affordability Schedule is also on the Connector’s website.
All that said, if you’re unemployed, as you indicate above, you are likely eligible for Commonwealth Care. I am happy to talk this through with you at any time; my email is ltucker@hcfama.org. And please do not hesitate to call our Helpline for assistance: 800-272-4232.
?,
For the purposes of state health insurance, a resident is someone living in Massachusetts with no intention to leave.
Thank you both,
Lindsey
Out of those 355,000 that now have coverage, how many of those are actually paying fair market value for coverage as opposed to those that are receiving Commonwealth Care?
Let’s do the math. Fair market value for a decent plan is anywhere from $300-500 per month. Let’s work the lower end of the scale of $300 per month. $300 per month x 355,000 equals $106,000,000 million per month. That’s nearly $1.3 BILLION dollars per year. That’s a conservative number considering that coverage gets more expensive with age.
I wonder from where that $1.3 BILLION is coming. It’s coming from you, the taxpayers. It’s coming in the form of fines, penalties, increased insurance costs, and mandated insurance coverage.
Universal health insurance is a silly idea. A smarter goal should be to make sure that everyone has access to medical care. Forcing an individual or a family to buy coverage to help cover those that can’t afford coverage is another tax.
An unelected board has determined the minimum and maximum tax that you will pay every year. This unelected board is made up of former insurance executives, union and business leaders. Not one person on this board has ever had to buy insurance coverage for themselves or a small business. In fact, most of the connector board has a background in the public sector. They have no conception of the tradeoffs between premium and deductible. In fact, I would bet that none of them have an insurance plan with a deductible and none of them even pay 20% of their premium. This is the independent board that makes decisions for you and I regarding what is affordable.
I’ll admit, I’m a broker and my business has grown due to this legislation. I have also had companies move out of state, reduce their workforce, or develop new corporations to skirt this law.
My prediction for the next 12-24 months is that the affordability scale will be raised due to the rising cost of living between heating oil, gas, etc. This means that more people will get subsidized or free coverage. Premiums for businesses and those that can afford it will increase by 33-50% due to the rising costs of free care.
Lindsey,
When you say state, you do not mean State?
$1.3 BILLION coming from you, the taxpayers. It’s coming in the form of fines, penalties, increased insurance costs, and mandated insurance coverage.