Setting the Record Straight re: Rick Lord on ‘BUR’s Blog
OK, first, Rick Lord, President of Associated Industries of MA, is undeniably one of the nicest guys in Massachusetts public policy. A business leader with a brain and heart. A good guy. So it makes sense for WBUR’s new blog to post him first. Unfortunately, as of about 9pm tonight, the reply function on their new site isn’t working — so we have to set some important factual matters straight right here instead of their site. Rick writes about the progress of health reform implementation. Fine until he gets to the money quote, about “minimum creditable coverage” and prescription drugs, right here:
Setting this standard too high will result in products that are simply not affordable for individuals at the lower end of the income spectrum. For example, requiring insurance products to cover prescription drugs will force 200,000 individuals who currently purchase health insurance to buy more expensive coverage than they already have. We do not believe this was the intent of the reform law that promised to offer individuals more choice and flexibility on selecting insurance products.
Two comments on the “intent of the reform law:”
1. At the ACT Coalition’s Monday press briefing on MCC, Rep. Patricia Walrath, House Chair of the Legislature’s Health Care Financing Committee and Chair of the Health Reform Conference Committee, stated with no margin for confusion her legislative intent that prescription drug coverage would be part of the MCC standard. Sen. Richard Moore, Walrath’s Senate counterpart, sent a written statement making the same conclusion.
2. How about Mitt Romney? What was his “intent?” Click here for Gov. Mitt Romney’s powerpoint presentation of April 6 2005, slide four.
“What is a Commonwealth Care Affordable Insurance Product?” is the headline.
First bullet: “This is not a ‘bare-bones’ product. Policy must include:”
Sixth item: “Prescription drug benefits”
Important Note: In April 2005, Romney referred to coverage for the under-300% population as “Safety Net Care,” and non-subsidized coverage for the over-300% fpl population as “Commonwealth Care.”
Intent? Unless Rick has some evidence to put on the table, it’s case closed.
Second comment: “requiring insurance products to cover prescription drugs will force 200,000 individuals who currently purchase health insurance to buy more expensive coverage than they already have…”
Correction — the MA Association of Health Plans released a single number, 200,000, claiming 200,000 current policy holders had coverage that does not meet the MCC standards being discussed by the Connector Board. MAHP did not provide any information on the cost of these policies — whether they meet the .60 actuarial standard, and if not, by how much. Nothing. Nada. Just the 200,000 number with no back-up documentation. Rick, we’ve been asking them to be “transparent” about their number since they released it a month ago, and they have refused to release any other numbers beyond 200,000. Maybe we can ask them together. In the meantime, there is not a shred of evidence to back up your statement.
John McDonough
February 28th, 2007 at 10:01 am
John–You know full well that it’s disingenuous for legislators to now say that it is/was the “intent” of Chap. 58 to include drugs in the definition of MCC. There is no evidence of this intent in the words of the statute. Isn’t it better for the Connector to work out this issue, especially the initial implementation, without a lot of posturing from the sidelines?
February 28th, 2007 at 11:19 am
I have heard enough about the 200,000 current subscribers who will have to upgrade to meet MCC. This is a fact based on current definition of MCC needing to include Rx coverage. These 200,000 are subscribers with the “Big Five” HMOs whose coverage does not include Rx. This is easily confirmed by the HMOs. Just give them a call. Futhermore there are at least 40,000 more subscribers that will have to upgrade because their coverages only provide a Rx discount card. These are the folks on Mega Life, MidWest Life NASE etc. Who is to say if these 240,000 subscribers can afford a premium increase or perhaps they will be pushed out the back door seeking an affordability waiver? Maybe John M knows but the rest of the world does not, including the Connector.
February 28th, 2007 at 11:46 am
Oh yes. I forgot to mention that all those enlightened people who have chosen consumer driven Health Savings Accounts(HSA)will not qualify for MCC since Rx can not be a covered benefit in the high deductible insurance plan (by definition). I do not know the exact number but I have heard 50,000 in Massachusetts bandied about. Undoubtedly most of these people will be able to afford an upgrade in premium but who is to say that “Big Brother” has the right to disqualify peoples choice of plans intended to be affordable by involving the subscribers in the medical process. My oh My, what has God wrought?
February 28th, 2007 at 4:37 pm
To friend Ed: I would take issue with your conclusion. The fact that Chapter 58 did not specifically include drugs in MCC may mean several things: 1. legislators assumed it was not an issue because Gov. Romney indicated these policies “must” include drugs, and including one benefit would have triggered a messy political process requiring them to spell out the full contours of the benefit package. or 2. they didn’t want drugs in, and are just posturing now.
The issue of “intent” was raised by Rick Lord, suggesting affirmatively that there was no intent to include drugs in MCC. The legislators are going on the record to challenge that assertion, and to state that it was their intent. We take them at their word. Their failure to include drugs in the statutory language precludes us from declaring it a closed issue — still, their statements on Monday make clear what they had expected. No more, no less.
To Mr. Appleseed: Actually, according to MAHP statements, not all 200,000 lack drug coverage. Some lack other elements of MCC and have drug coverage. And because we have zero data on what the 200,000 are paying premiums now, and we do not know the elements of their benefit packages, we cannot make conclusions about how many will have to pay a “premium increase” or not, or how much of an increase.
Only full disclosure by the health plans can help us to answer these questions.
John McDonough
March 1st, 2007 at 10:54 pm
If the legislature’s “intent” was/is to include prescription drug coverage as part of MCC, why doesn’t the Legislature pass a law to mandate Rx coverage? They’ve passed plenty of other insurance mandates. Am I missing something?
March 19th, 2007 at 4:40 pm
[...] Setting the Record Straight re: Rick Lord on ?BUR?s Blog OK, first, Rick Lord, President of Associated Industries of MA, is undeniably one of the nicest guys in Massachusetts public policy. A business leader with a brain and heart. A good guy. So it makes sense for WBUR’s new blog to post him first. Unhappily, as of about 9pm tonight, [.] (more) [...]