Health care reform in Massachusetts is complicated, placing new responsibilities upon employers, individuals and state government. As an organization representing employers, A.I.M. has been working closely with the state agencies responsible for developing the rules governing new employer requirements. Our recent experience with two state agencies – the Division of Unemployment Assistance (DUA) and the Department of Health Care Finance and Policy (DHCFP) – around the new reporting requirements for the so-called “Fair Share Contribution” has been very positive.

As observers of health care reform know, the law requires all employers in Massachusetts with 11 or more employees to make a “fair and reasonable” contribution to their employees’ health insurance premiums or pay a “fair share assessment” of $295 per employee per year to the state. A subsequent regulation outlined the test that would determine if an employer made a fair and reasonable contribution, consisting of two parts: (1) are 25% of the full-time employees enrolled in the employer’s health insurance plan, or (2) does the employer contribute at least 33% of the premium.

In July DUA, which is the agency responsible for collecting the fair share assessment, formed a pilot group of 25 employers to “test drive” the proposed methodologies for each of the tests. It became evident almost immediately that the methodology for collecting and reporting information for the first test was extremely complex and administratively burdensome. As a result, both DUA and DHCFP are working with A.I.M. to develop a more streamlined procedure without changing the original intent of the two-part test. A.I.M. applauds both agencies for their responsiveness to the concerns of the employer community, and for their thoughtful approach to addressing the issues we identified.

I write about this recent experience because in a small way it exemplifies the extraordinary collaboration that has occurred over the past three years in Massachusetts in our efforts to provide insurance coverage to all of our citizens. The willingness of all parties – businesses, insurers, health care providers, advocates and government officials – to work together to overcome obstacles and differences of opinion before they become serious impediments to progress is the distinguishing feature that has made Massachusetts the national leader in health care reform. All involved can take pride in our common effort in pursuit of our common goal.

Richard Lord is President and CEO of Associated Industries of Massachusetts.

Everyone involved in the health care reform effort in Massachusetts should be proud. In just a little over a year, we have reduced the number of uninsured residents in the state by more than one-third and we are continuing to make progress each month. Policy makers nationwide are watching Massachusetts closely to determine if this is a model for reform in other states or at a national level or whether, at the very least, some components of our reform law could be replicated elsewhere.

As other bloggers have suggested, however, we certainly cannot ignore the very real threat to the success of our program in Massachusetts unless we seriously address the issues related to rising health care costs. After almost a decade of double digit cost increases we are beginning to see some slight slowdown in premium increases, but they are still growing at more than double the rate of regular inflation. Under health care reform, our state government has assumed a significant new burden that is not sustainable unless we tackle this very complex issue.

Since July of 2006, more than 50,000 people have signed up for the state’s Medicaid program which had over one million enrollees already – almost one of every six Massachusetts residents participates in this program. Since last October, over 92,000 individuals who earn less than 300% of the federal poverty level have signed up for heavily subsidized health insurance in a new state program called Commonwealth Care. It is great that all of these people now have access to health coverage. However, this also places very serious pressures on the state’s finances. We must immediately focus our collective attention on steps that can be taken to bring the costs of health care under control.

Of course none of this is going to be easy. But then again, two years ago very few people would have predicted that virtually all of the interest groups in Massachusetts – business, labor, advocates, insurers, providers, and government – would be able to reach a compromise to expand health care coverage to almost all our citizens. These same groups must now pledge to work together in a similar manner to ensure that the great progress we have made will continue in future years.

Richard C. Lord, President and CEO
Associated Industries of Massachusetts

One of the key components of health care reform, the individual mandate, is just around the corner. On July 1st, Massachusetts will be the first state in the nation to require its residents to obtain health insurance coverage. The entire country is watching this bold experiment in the hope that our ambitious plan can serve as a model for other states in expanding access to the uninsured.

In addition to the individual mandate, there are a number of other provisions in the new law which employers are gearing up for as well. Read more…

A.I.M. and the Massachusetts employer community are proud to be at the forefront of the state’s landmark health care reform program. We are pleased that its implementation is proceeding reasonably smoothly, and that it has already achieved a significant part of its intended purpose of reducing the number of the uninsured. There will continue to be challenges, both for individuals and employers, particularly beginning on July 1st, when both of the new employer responsibilities become effective.

The progress we are making, however, only re-emphasizes the imperative need to address the cost issues that were largely bypassed in framing the reform act. Health insurance costs have been the number-one issue for employers for years; more recently they emerged as a major problem for municipal governments; with the individual mandate looming, we are now hearing complaints about high costs even from health care and social service advocates who long ignored or depreciated our concerns. The board of the Commonwealth Heath Insurance Connector Authority, on which I serve, has struggled to devise “affordable” health plans to extend coverage without undue financial burden. A.I.M. will continue its work by convening the state’s leading employers around cost containment issues – but we hope to do so as part of a broad public deliberation in which all parties and interests participate.

Richard Lord is President and CEO of Associated Industries of Massachusetts

Associated Industries of Massachusetts has been conducting briefings across the state in conjunction with the Commonwealth Health Insurance Connector Authority to inform employers about their new responsibilities under the Massachusetts Health Care Reform Law. We have completed seven briefings so far and will be traveling to Pittsfield and Cape Cod in the next few weeks.

Complying with all of the requirements of the new law is definitely a challenge for employers, particularly those with a significant number of non-traditional employees, e.g., seasonal, part-time and temporary workers. Read more…

How is health care reform going in Massachusetts? Very well so far – although that is not necessarily the impression conveyed by media reports. Read more…