What are your thougths, feelings, questions about the requirement that all adults in Massachusetts have health insurance? Let us know this Tuesday, the 18th, from 1 -2 pm when WBUR will host a call-in show on the law. You can post questions here in advance or call during the hour. December 31st is the deadline for obtaining a health plan if you want to avoid a penalty.

Here’s the press release.

Here’s the agreement.

Here’s an article with more background from the Providence Journal.

At least there will be more money for affordable health insurance in RI.

Community Catalyst summarizes a report the group released yesterday…

Community Catalyst, a national consumer health advocacy organization, has released an analysis of the first year-and-a-half of Massachusetts’ comprehensive health reform package. The report finds early success in the program due to robust enrollment, largely in subsidized programs for people with the lowest incomes. However, the study also stresses that certain uncertainties and challenges remain in future implementation phases for the law, particularly regarding the individual mandate and long-term financing of reform.

WHILE NO ONE KNOWS HOW MANY MASSACHUSETTS RESIDENTS WILL CONTEST THE NEW HEALTH INSURANCE REQUIREMENT… ONLY A HANDFUL HAVE FILED FOR AN EXEMPTION. OF THE 46 APPLICANTS, 19 WERE APPROVED. MOST OF THE BALANCE QUALIFY FOR STATE SUBSIDIZED COVERAGE. THE HEALTH INSURANCE CONNECTOR’S GENERAL COUNSEL, JAMIE KATZ, SAYS TAXPAYERS CAN ALSO CLAIM AN EXEMPTION WHEN THEY FILE THIS YEAR’S STATE INCOME TAX FORMS.

Most people who have this issue of whether they have to pay a penalty or not will deal with it through the tax return. They will file a schedule. They’ll at that point determine whether they are in or out.

THE STATE ESTIMATES THAT 60-THOUSAND RESIDENTS WILL BE EXEMPT FROM THE INSURANCE MANDATE BASED ON THEIR INCOME AND COST OF HEALTH PLANS. IT IS NOT CLEAR HOW MANY PEOPLE WHO DON’T FIT THE AFFORDABILITY GUIDELINES WILL ALSO ASK FOR A WAIVER.

Last week, state leaders, business organization, health care advocates and others joined to celebrate the fact that by the end of this calendar year, some 300,000 Massachusetts residents who were uninsured a year ago now have health insurance. This is an accomplishment that no other state can claim, and it is a substantial improvement over the trend in health insurance on the national level.

One of the media representatives in the audience that day at the State House asked, “How many uninsured residents are left?”

At this point, no one really knows. There are, of course, estimates, but they vary widely depending on timing and methodology. Read more…

While the discussion goes on about the issues of cost and quality, one thing that no one can debate is that to improve, those delivering care need good data. Whether we choose to view it as a deficiency of the current system or an opportunity, the fact is that those delivering care do not now have access to enough information to get us from where we are to where we need to be.

The health plans currently control most data that exists in an electronic format (No one believes that using paper-based data can be useful over the long run.). But there is no agreement among the plans regarding making this available to providers in a uniform format. At this time, plans release information in differing formats (sometimes paper based), covering different spans of time and different subjects. From this, providers of care are expected to try to provide a uniform standard of care to all of their patients and improve what they do.

This has not worked and it is not hard to see why. Read more…

CVS’s MinuteClinic has once again incited a healthy debate as the Public Health Council prepares vote this Wednesday on whether to allow limited-service medical clinics to open in retail stores throughout Massachusetts. The emergence of these retail clinics is another reminder that listening to what patients want and providing them with quality care is paramount to our health care system.

Advocates for the clinics argue that they fill a gap in the health care delivery system by relieving overbooked primary care physicians and eliminating unnecessary emergency room visits. Yet detractors, including Mayor Menino, believe there is a marked risk in fragmenting patient care; the development of serious conditions could be missed without knowledge of a patient’s full medical record history. The mayor also pointed out that retail clinics would add another layer of care that is not coordinated with a patient’s existing medical team, further splintering the coordinated care model.

Regardless of which side of the debate you’re on, one lesson is clear: Health care providers need to continue finding ways to make high-quality, coordinated care accessible to our patients when they need it. Read more…

The Taxpayers Foundation has just published the first comprehensive analysis of the broad scope of employer participation that is essential to the success of Massachusetts health care reform. Our report finds that employers will increase their health care spending by about $175 million a year as more employees accept employer-sponsored health insurance and as employers add new prescription drug benefits to help employees comply with the Connector’s minimum creditable coverage standards.

The beauty of the Massachusetts law is that it uses a combination of individual and employer incentives and responsibilities to build on our state’s historically high level of employer-sponsored coverage, increasing both the number of insured and the amount employers spend on health care by creating a strong incentive for previously uninsured employees to sign up for employer health coverage. Our study estimates that 50,000 employees and dependents who were previously uninsured will now enroll in employer coverage, increasing employer spending by about $150 million a year. Employers will spend an additional $25 million to offer employees new prescription drug benefits.

Our analysis highlights the fact that employer participation in health reform goes way beyond the so-called “fair share” provisions that have received most of the public comment and have been widely misunderstood. Read more…

Last week, the Patrick administration and the Connector Board shared the news that 300,000 residents now have health insurance, and these numbers are still climbing week by week.

And as we conclude the first full year of our efforts to provide health insurance coverage to nearly all Massachusetts residents, this administration, members of the business community, healthcare advocates, and providers remain committed to our approach of shared responsibility.

As a longtime healthcare advocate, I remain firmly committed to the true spirit of the law, which is ensuring that individuals are only asked to purchase insurance if it is affordable. The law recognizes that at rates of 10-12% medical inflation each year, individuals are uninsured in Massachusetts simply because they can’t afford it.

Massachusetts has made incredible progress by providing affordable, comprehensive coverage this first year, and we have some very valuable lessons to share with our fellow states on the verge of healthcare reform and the nation:

Lesson #1: Most states don’t know how many residents are uninsured. Massachusetts is no different. Read more…

Massachusetts’ health care reform means that more than 300,000 people in Massachusetts have signed up for health insurance in the past year and no longer have to fear getting sick or waiting until they are severely ill before they seek care. By all measures, this is good news, and ongoing outreach and enrollment efforts are moving the Commonwealth closer toward universal coverage.

As more and more individuals acquire insurance, we must recognize that insurance does not ensure access. Having a regular provider and a regular place to go for health care is necessary to ensure that people get the right care in the right place.

The demand for primary care providers in Massachusetts is on a lot of people’s minds. Anecdotally, people relate that primary care providers are a scarcity, that wait times to see a provider are often unacceptably long and that too many providers are not taking new patients.

Despite one of the highest physician to population ratios in the country, a smaller percentage of physicians in Massachusetts practice primary care. There are simply not enough providers to meet Massachusetts’ evolving health care needs, given the increasing enrollment in managed care plans. Read more…