Massachusetts: Not so universal health care

Robert Laszewski at Health Care Policy and Market Review sounds off on the recently released details of the individually mandated health care reform in Massachusetts. Laszewski believes there is too much of a rush to call the reform a success, saying "The only place there are more victories being declared than in Iraq these days is in Massachusetts."

Facing cost issues, The Commonwealth Health Insurance Connector Authority plans to exempt 20% of uninsured adults from the new state requirement to buy health insurance. Costs are simply too high to enforce a mandate for everyone. An estimated 60,000 people who are low income but do not qualify for state subsidies still will not be able to afford health insurance.

Under the program, a family of three earning $50,000 per year will have a health insurance plan available to them but it will cost about $7,000--and that plan has a $2,000 per person deductible. Before the Connector's ruling on exemptions, that was mandatory. Now, a family making $50,000 is exempted from the mandate if it can't find a plan for less than $3,840 per year. Based upon the "Connector's" health insurance rates, they won't find one.

To keep some perspective on the matter, those exempted constitute only about 1% of the state's population. The problem is, the people in that 1% are among those who need health insurance most. The Massachusetts plan is not a bad one, Laszewski concludes, but the issues coming up now show that states can't pull off universal health care alone.

The lesson is that a state cannot do it all by themselves.

In Massachusetts, the good news is that the glass is half full--a lot of people will have coverage who didn't before particularly between 100% and 200% of the federal poverty level.

The bad news is that the glass is half empty--lot's of people have been "exempted" from the new universal health care coverage mandate but still can't afford it. And on this point, Massachusetts has hit one big brick wall--and they don't have the means to go further.

That isn't trash talking. It is the reality we all need to face when trying to understand what the Massachusetts health care reform law means to the rest of us.

Links:
Laszewski: Another Victory Declared in Massachusetts--The Connector Exempts 20% of Uninsured State Residents From the Requirement to Buy a Health Plan
Boston Globe: Health plan may exempt 20% of the uninsured