The most recent enrollment numbers indicate that approximately 200,000 individuals in Massachusetts, who were uninsured 16 months ago, have health care coverage today. That certainly is great news and should be celebrated by all of those who have been involved in the health reform effort in the Commonwealth. However, a closer examination reveals that most of those newly covered individuals are either enrolled in the state’s Medicaid program or are receiving heavily subsidized insurance through the state’s new Commonwealth Care program. Although that is not totally unexpected – why wouldn’t anyone enroll in programs that provide free or almost free health care – the increased costs to the Commonwealth could present future fiscal concerns. Additionally, it will be very interesting to see whether higher income residents not eligible for subsidized care comply with the looming December 31st deadline when penalties begin to kick in.
The Massachusetts health care reform law mandates that individuals over the age of 18 must have health insurance. Recent profiles of the uninsured indicate that there are significant numbers who a) are relatively young and b) earn above 300% of the federal poverty level and are therefore not eligible for state subsidies. Many of these individuals do not perceive the value of having health insurance because they are young and healthy and do not want to pay premiums that are not inexpensive, even for the young adult plans which have recently become available for 19-26 years olds through the Connector.
The requirement that individuals must have health insurance is a novel one which has never been tried anywhere else in the country. It should not be expected that we can change attitudes and perceptions overnight which is one reason that the Legislature, in its wisdom, created a fairly modest penalty in the first year for non-compliance with the law, i.e. individuals will forfeit their personal tax exemption when they file their 2007 tax returns, which amounts to a penalty of approximately $219. However the financial penalties in future years increase substantially.
There has been a concerted effort by both the Connector and Massachusetts Health Care Reform Coalition (of which AIM is a member) to educate our citizens about their responsibilities under the new law. However recent polling data reveals that the majority of individuals are still neither aware of the deadline for obtaining coverage nor the financial penalty for failure to do so. Obviously the public awareness campaign must continue and be enhanced. Even more difficult is the challenge to convince individuals who do not see value in having health insurance that it is in their best interest – both from a personal health and financial perspective – to obtain coverage.
Richard Lord, President and CEO, Associated Industries of Massachusetts
“Approximately 200,000″? Not bloody likley according to the EOHHS report and the data pesented at the board meeting of the Connector in Oct.
Children’s Expansion up to 300% FPL
On July 1, 2006, MassHealth implemented expansion of MassHealth Family Assistance coverage to children in families with income greater than 200%, and up to 300% of the FPL. As of August 2007, there were 53,500 children enrolled in Family Assistance, up from 31,000 in June 2006. More than 16,800 of those children are new members and/or converted Children’s Medical Security Plan
members enrolled as a result of the income expansion.
MassHealth Essential
Effective July 1, 2006 the enrollment cap for MassHealth Essential was increased from 44,000 to 60,000. This allowed MassHealth to enroll more than
12,000 applicants who were on a waiting list at that time. As of August 2007,Essential enrollment was 52,700. Given the amount of additional enrollment capacity for the program, MassHealth does not anticipate having to reinstate the waiting list for Essential
Commonwealth Care
As of October 1, over 127,000 people have enrolled in Commonwealth Care, over 26,000 of which are in premium paying categories.
Commonwealth Choice
As of October 1, 8,306 individuals have enrolled in health insurance plans through Commonwealth Choice.
MassHealth
Children: 16,800
Adults: 16,000
Commonwealth Care: 127,134 (about 26,000 paying any premiums at all)
Commonwealth Choice: 8,306 (out of projected 250000)
Total = 168.204
Numbers from the periodic 60 day report by EOHHS (10/12/07) and the Operations Report to the Board of the Connector at the Oct. meeting.
So how does the number 168,204 transmute into 200,000? A difference of 31,706 is 18.88% MORE than shown by the reports – hardly insignificant and most definitely NOT “approximate”! Exaggeration is so tacky and damages the crediblity of the speaker.
Ann’s accounting leaves out two other groups of the newly insured. Adding them in leads to over 200,000 newly insured.
First, MassHealth has experienced membership growth in addition to the new children and Essential members. Growth has come mainly among families, and the expanded Insurance Partnership. Altogether, the net growth in MassHealth since July 2006 is 55,148.
Second, people have been joining private insurance plans apart from the Connector-sponsored Commonwealth Choice plans. All of the major insurers are advertising heavily, driving consumers directly to their plans. At a Connector meeting this summer, it was announced that a survey of the major health plans showed a net growth of 15,000 newly insured. That number is certainly higher today.
Adding all the numbers up (CommCare: 127,134; MassHealth: 55148; CommChoice: 8306; Private insurance: 15,000) totals almost 206,000.
While we are still a distance from universal coverage, providing coverage to this mostly low-income group of residents is an achievement we should welcome.