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Preview of House Health Access Reform Bill

October 31, 2005

Today, the House will unveil their healthcare plan that leaders claim will cover 95 percent of the state's roughly 500,000 to 748,000 uninsured within three years. This will be done without any new sources of tax revenue.

The legislation requires all residents to have health insurance, imposes new assessments on employers and offers tax breaks to businesses providing insurance. It also expands eligibility for Medicaid as well as the creation of low cost insurance products. In a version of pay or play, businesses with more than 10 employees would face a financial assessment by the state if they did not provide healthcare coverage to their workers.

In yesterday's globe Timothy Murphy, state health and human services secretary countered ''We believe it's unnecessary to have an employer mandate as a way to get everyone insured." The coming weeks will reveal a fight over the size and scope of the reform and over the formula for distributing it's dollars. ''It's all going to be about who's ox is getting gored," said Terry Dougherty, vice president for payer and HMO relations at Caritas Christi Health Care System, as quoted in this morning's Boston Globe.

Under the proposed Medicaid expansion, eligibility would be extended to children in families earning up to 300 percent of the federal poverty level, or $38,500 for a family of two. Medicaid coverage for parents would be expanded to those earning up to $32,300 for a family of three. The bill also opens up Medicaid eligibility to adults without children if they earn less than the federal poverty level.

The House plan also would provide subsidies, and it envisions low-cost policies that many more people will be able to afford. But instead of scaling back some benefits, as Romney would, House leaders believe they can craft a roughly $320-per-month plan by allowing insurers to charge higher deductibles and co-payments.

Hospitals would see an $80 million increase in Medicaid rates tied to performance goals in the areas of quality, efficiency and improved patient outcomes. The Free Care Pool would be replaced with a Health Safety Net Fund that would fulfill a similar purpose but would reimburse based on a new standard fee schedule. As more people secure insurance pool dollars will be transferred to the subsidy program.

Below are links to two Boston Globe articles on the subject
Health plan pressures Mass firms
Many seek advantage in plan for healthcare

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Preview of House Health Access Reform Bill

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