8:48am: Andover. Old brick former manufacturing building. Raining hard – everyone feels less guilty being here. Cancelled soccer games.

John Spencer facilitator. The goal is not problem solving. This is about framing and how the board will go forward.

Leslie Kirwan: What a year it was. … Looking ahead, and over the winter, we see there are many decisions to be made, and we will look at results from the first year. Two major dynamics – continue to focus on enrollment and the outreach efforts … The tone is shifting toward sustainability and what role we have to play in sustainability. …. Each one of us has a different view of what that means to continue what we’ve done … to make this program work and be successful …

Jon Kingsdale: Clearly wrestling with costs today. … Important to wrestle hard and concretely with this issue – this is not just education.

Key Takeaways:
1. Controlling costs is key to sustaining Mass Health Reform (MHR)
2. Key pieces are so inter-dependent that one ‘failure’ will ricochet throughout.
3. C.58 gives this Board select levels to pull (or not) over the next 5 months.

Individual Mandate is about helping everyone get insurance so insurance is more affordable for everyone. Interdependence of key pieces is important to recognize. While it’s all a big ball, the Board has some specific levers. We’re going to focus on what it is you do control.

This morning: First half: health care spending/Commcare. Second half: board levers/other state levers.

Interdependences:
Cost to state government of MHR
CMS Waiver Renewal
Health care Cost Trend
Gain loss of ESI and direct pay (crowd out)
Number of uninsured.