“Jesus sat down opposite the place where the offerings were put and watched the crowd putting their money into the temple treasury. Many rich people threw in large amounts. But a poor widow came and put in two very small copper coins, worth only a fraction of a penny. Calling his disciples to him, Jesus said, “I tell you the truth, this poor widow has put more into the treasury than all the others.” Mark 12:41-43 (New International Version)

Through the lense of this powerful text, what can we observe about the current contributions being tossed into the treasury set aside to fund healthcare reform?

GBIO leaders, who have been knocking on doors this summer letting people know about the new healthcare law, have begun to discover an answer.

In our work we have encountered three kinds of people at the door.

(1) Those who are insured through their employer, through MassHealth or are new Commonwealth Care enrollees.

(2) Those who are uninsured, most of whom will qualify for Commonwealth Care.

(3) Those whose employers offer them coverage, but it is too expensive, and remain uninsured.

This last group of people is the most difficult, because we have absolutely nothing to offer them.

Here are 2 stories taken from the lives of two people whom we encountered during our enrollment work. These stories exemplify the challenge faced by thousands. For purposes of anonymity I will withhold their names.

A single woman from Upham’s Corner, in her early 50’s, works the evening shift at a large chain store. She earns about $18,000 a year. Her employer offers her a high deductible plan for approximately $150 dollars a month. $150 dollars a month is too expensive given her low salary and the cost she incurs for caring for her disabled adult son.

A young man on Dale Street in Roxbury is turning 27 in October. He works for a security firm that offers him coverage for $75 dollars a week; that’s $300 a month for a single adult with no dependents. Earning less than $30,000 a year, he simply can not afford this coverage.
These 2 individuals and the thousands of others like them will be affected by the dollars made available to fund healthcare for all of our residents. This brings us to what I believe is a critical problem facing the implementation of our new healthcare law – the fair and reasonable regulations.

The foundation for funding healthcare in our Commonwealth is based on an agreement of shared responsibility. State government, business and citizens (through the individual mandate) all must make a contribution. How are these contributions distributed currently? Through the metaphor of our text, we see state government placing more than 400 million dollars out of the general fund for 2008 into the offering box, a figure that will increase substantially in 2009. We see individuals from an overburden middle class, many like the widow in the text above – barely making it, but mandated by law to put in their little bit – and are beginning to do so. But what of business, particularly those who provide no insurance under the fair and reasonable standards of Chapter 58? You know those dismally low standards that say employers must cover only 25 percent of their workforce or merely 33 percent of the insurance premiums for their employees or pay a meager annual fine of $295.00 per employee. Those who earn millions are required only to put in a mite, a fraction of a penny. This is neither fair nor reasonable – but it is law.

According to Alice Dembner in a May 10, 2007 Boston Globe article: “Penalties on those businesses were expected to bring in $95 million this fiscal year and $76 million next year, according to the Legislature’s estimates when the bill was signed into law a year ago. But the state now expects to collect nothing in the fiscal year that ends June 30 and only $24 million next year, according to budget officials in Governor Deval Patrick’s administration and in the House of Representatives.”

This reality is neither fair nor reasonable! We will never be able to find an answer for the two stories from Roxbury and Upham’s Corner and the thousands they represent with this lack of responsibility.

However, recently we have seen some signs of hope. We applaud Blue Cross Blue Shield Insurance Company for announcing on Friday that they will reverse their initial plan to lower the minimum standard for employer contribution to healthcare and instead will keep the level at 50%. On behalf of the two unnamed citizens noted above from Upham’s Corner and Dale street in Roxbury, we thank Governor Patrick for weighing in on this issue and Blue Cross Blue Shield Insurance Company for reconsidering their plans and keeping the interests of low income employees in mind and providing the moral and financial leadership to raise employer contributions across the Commonwealth to a more fair and reasonable rate.

While this move gives us hope, we join with Senator Moore and others in calling on Governor Patrick to take regulatory action to ensure that all employers in fact contribute a truly fair and reasonable amount or pay a reasonable employer assessment – one that might actually aid us in providing insurance for those who currently can not afford what is offered by their employers.

Rev. Hurmon E. Hamilton, Jr
Senior Pastor of Roxbury Presbyterian Church USA
Chairman and CEO of Roxbury Presbyterian Church Social Impact Center, Inc.
and President of the Greater Boston Interfaith Organization