As the debate over the funding of health reform reaches a critical juncture, several key points should guide the discussion:
- It is essential that state leaders and others get a better handle on the scale and nature of the “problem” that needs addressing. For example, what are the factors that are driving the larger than anticipated enrollment in Commonwealth Care? Is enrollment likely to peak in the next year or will it continue to grow indefinitely? National medical inflation is driving up health costs for everyone so we need to focus on the incremental increase in state spending beyond the norm.
- There is a danger that revenue raising proposals, unless carefully thought through, could undermine the longer term sustainability of health reform. One of the key underpinnings of health reform was to encourage individuals to accept employer coverage. This is working, according to a recent survey by the Massachusetts Association of Health Plans, which concluded that an additional 85,000 individuals enrolled in employer-sponsored coverage in 2007 at a time that employer coverage is dropping in most other states.
- The funding of health reform is part of a large fiscal challenge facing state leaders and should be addressed in that context. The Governor’s proposed budget for fiscal 2009 already relies heavily on one-time or speculative revenues. The impact of the recession on tax revenues will only make the situation worse. The shortfall in funding for health reform is a small part of a much larger fiscal problem.
- Political support for health reform remains strong and a broad spectrum of stakeholders is committed to addressing the issues that have arisen. This spirit of cooperation is critical to the law’s success.
Michael J. Widmer
President
Massachusetts Taxpayers Foundation
Employees in this state were not “encouraged” to enroll in employer based coverage. The law made it a requirement. Those that signed the waiver are now facing tax penalties. They were co-erced, by the new law, that made “insurance” mandatory. This law took away one of peoples most basic rights, the right to choose. Most of the people who weren’t enrolling,previous to chapter 58,were doing so because the price to enroll did not leave them with enough disposable income to pay their childcare, heat, rent and food. That was a choice they had to make. Now they have no choice but to face penalties and fines. The numbers you refer to, from other states,only show that it is a national problem. Masssachusettts residents weren’t doing anything, that others weren’t doing. Until we deal with the waste and cost, we haven’t reformed anything. The cost issue should have been dealt with first.We’re still seeing our health care dollar wasted. It was wonderful to hear that the state was going to help all of these people pay for their insurance, the problem being they underestimated the numbers of uninsured as well as the numbers of people living within the expanded poverty level in Massachusetts. The numbers are huge. Universal health insurance is NOT Universal health care. I certainly hope the strong political support, you refer to for this reform plan, does not equal George Bushs’ strong support for the war. The legislature must recognize the mistakes they’ve already made, and go back to the table and rethink this “insurance” mandate. Part of the reform plan was also to reduce the Medicaid roles. I see we have increased that by 60,000 or more. There has been no victory here in Massachusetts. The stakeholders, for the most part, are wealthy and unaware of the numbers of working poor in Massachusetts. Did you see the reported increase in people utilizing food banks? It’s not all related to the price of gas, most folks are now opting for the T.