Yo Jack,
Great to see you at the family dinner last week. I loved hearing your band’s new song, Naked on the Inside, particularly now that I understand that it’s not a tale of adolescent angst and the search for connection, but just about sex.
So, you had a lot of good questions about the state’s new health insurance law.
I agree, it’s weird that the state called its new health plans “Commonwealth Choice” when lots of people won’t have a choice about whether or not to buy them. I’ll pass that comment along to the people who make up the names. I can also understand why you think it’s age discrimination that the plans don’t cover the costs of tattoos, piercings, and herbal medicine. Read more…
We will occassionally post the stories and questions of Massachusetts residents who are uninsured. This entry is from Chris, a 37 year old college instructor, who lives in a suburb
west of Boston.
Here’s Chris…
As a part-time employee, I am wondering whether my employer will be required to offer me any medical insurance. I am guessing not from my survey of various web logs, news reports, and the Connector’s web site. There is discussion in all of these places
about the requirements for covering full-time employees, but I haven’t found any mention of what will happen to part-timers.
I am assuming that I will be required to purchase my own medical insurance without government subsidy. This assumption is based on my income from last year, which was above the benchmark of 300 percent of the Federal Poverty Level. As a part-timer, though, my income varies from year to year. This makes me wonder whether I will need to move from health plan to health plan, as one year I may qualify for Commonwealth Care, and the next, not. If so, this would require a lot of time and effort in filling out applications, providing proof of income, informing organizations of my previous coverage, transferring records to new
doctors, etc.
Read more…
Access to health insurance is not the same as access to health care. Forcing modest-income families to buy insurance policies with huge deductibles, co-payments and co-insurance may help hospitals, but leave patients even worse off than when they were uninsured.
For the much-vaunted monthly premium of $175 (that’s for a young person, for someone my age it’s $347), you can get “coverage” through The Connector. But the coverage comes with a $2,000 deductible. And even after you’ve reached the deductible you’re stuck with 20% of the bill for inpatient care, outpatient surgery, physical therapy, etc. The real insurance only kicks in after you’ve spent $5,000 out-of-pocket for covered services. (Non-covered services don’t even count toward the deductible. So if you tear an ACL playing soccer and need 6 months of physical therapy, you’ll be responsible for all those bills after the first 3 months – about $2500 on top of the $5000).
For window dressing, the coverage allows you cut rate doctor visits – $25 each time – and drugs have their own complex deductibles and co-payments. But once you sort through the fine print, the message is clear: If you’re actually sick you’re in deep financial trouble. Read more…
As with a recent radio show promotional contest, “you can’t win, if you don’t ask.” Well, so goes the future of Massachusetts’ Health Reform. If employers and individuals don’t ask, and understand, the future success of affordable access for all residents will be at risk.
It is a big change for everyone involved. And, it is why hospitals are engaged in a major awareness and information campaign for the under and uninsured. This campaign includes brochures and posters in fourteen languages at hospitals and health centers around the state in order to assist individuals in signing up for insurance coverage, if not already enrolled. Also, there is a new website – www.gethealthcoverage.net. Read more…
The recent loosening of the affordability standards by the Connector for our residents was an important step and acknowledgement that we need to go slow on this unique reform. The long term economic and political viability of the reform demands that we be patient, flexible and understanding as to the financial and personal needs of everyone affected.
It is difficult for many of us with generous health insurance coverage to be able to fully relate to the situation of those not currently insured. Those who cannot afford to make that investment need to have help and time to make the adjustment. There are also those that can afford coverage, yet do not take insurance because they view themselves as healthy and even “self-insured.” Understanding and flexibility should be granted to this large group of residents, most of which likely do not yet fully comprehend their coming responsibility under the law.
Read more…
There is nothing like talking to an outsider to get some perspective on a public debate.
This past weekend, my family entertained a friend from New York. Although not in the health care field, my friend is interested in policy innovation and social change. (He works on public education reform.) He peppered me with questions about our health reform law. How is the state deciding who has to buy insurance? How is the public reacting? Is the political consensus holding? Read more…
State of the Union Address, 2010. The First Lady (or First Guy), seated in the visitors’ gallery of the House of Representatives, is flanked by Shirley Needing and Harold Heart (fictional previously uninsured folks used as sample beneficiaries of Senator Ron Wyden’s health care plan). After a brief discussion of foreign policy, the President identifies Shirley and Harold as newly-insured beneficiaries of the federal universal health insurance plan, and they get a standing ovation.
How do we get there from here? How would a new federal health insurance plan interact with the Massachusetts system under Chapter 58 for the Shirleys and Harolds of Massachusetts?
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans. What began as a law to provide minimum standards and protections for private benefit plans has become a major obstacle to health insurance reform.
A state can mandate an individual to buy health insurance, but it can’t mandate a business to provide insurance, because of ERISA. Read more…
Is Massachusetts health reform the American Idol of other states? Will we be sent back to the drawing board? Will Commonwealth Care be affordable? Will we achieve real health reform? Cast your vote on the CommonHealth Blog.
Reading the various entries of my co-contributors this past month I’d say the jury is still out but it’s not looking good. Here are some quotes from some recent entries:
“Unfortunately, it gives people access to the same health care system that is accused of being too costly, to have variable quality, be inefficient, unfriendly, and inaccessible… We need to review and reconsider a single payer system and determine whether administrative simplification has the merits promised.” – Carl A. Soderland, M.D.
“Massachusetts has been the first state to take on the issue of covering the uninsured. Could we also lead the way in taking on the challenge of making healthcare more affordable?” – Christina Severin
Lots of folks look at Chapter 58 and say, “ugliest piece of s___ I ever done seen!” Others look and say, “Not too shabby. We could have done worse. Let’s figure out how to use it the best we can, and then figure out next steps.” – John McDonough Read more…
One of the key features of the health reform law is that it represents a true partnership among government, employers, and individuals. While the discussion of employer responsibility has centered on the “fair share” assessment, a much more critical element has been largely ignored – namely, under health reform there will be a major increase in employer-funded insurance to cover those employees who previously declined employer-offered
coverage but will now accept it because of the individual mandate.
An estimated 100,000 of the state’s uninsured are working for employers who provide health insurance; the majority of these individuals will take that coverage for the first time under health reform. This will produce a major infusion of additional employer dollars into the health care system – a minimum of $200 million and probably much more. This is several orders of magnitude larger than the estimated $31 million to be raised by the fair
share assessment. Read more…