Yesterday’s Boston Globe included a front page story on the problems of underinsurance. Underinsurance is a glass half-full/half empty story. It’s a real problem, but we’re making progress.
The Globe cited results of an unreleased Globe-Blue Cross Blue Shield of MA Foundation study that found that some of Massachusetts’ insured residents have plans with significant cost-sharing that create barriers to needed medical care. According to the survey, 13% of insured residents have unaffordable medical bills and 9% said they were forced to forgo or delay needed medical care because of their medical debt. Some 14% have failed to fill a prescription in the last year because they could not afford the cost-sharing.
This is not surprising – it’s not a new phenomenon, nor is it isolated to Massachusetts. In fact, underinsurance rates are decreasing in Massachusetts (thanks to health reform) and they are far lower in Massachusetts than they are in other states. The article also cites the recent Urban Institute study that found that the state’s underinsurance rate has dropped substantially since health reform implementation began and that underinsurance is a problem for three times more people nationally than in Massachusetts.
Underinsurance is a major threat and one that Massachusetts must continue make strides against. The ultimate goal of health reform is access to care not just access to coverage. Having an insurance card does you no good if you can’t get access to the care that you need. Thanks to health reform, we have the tools we need to take this threat head-on. The legislature wisely included two provisions to address underinsurance in Chapter 58 – the Minimum Creditable Coverage standards (adopted by the Connector, they set the baseline of insurance coverage that residents must have to satisfy the individual mandate) and the Minimum Coverage Standards (to be adopted by the Division of Insurance, they will set the baseline of insurance coverage that can be sold in Massachusetts). Only by ensuring adequate MCC and Minimum Coverage Standards can we ensure that the coverage that is sold in Massachusetts, and the coverage that people must buy to satisfy the individual mandate, provide all insured with adequate access to care for their basic health care needs.
Lisa Kaplan Howe