Details of Ambitious Health Care Access Plans Begin to Emerge
By Amy Lambiaso for the State House News Service
       Details of competing plans to expand health care access in Massachusetts emerged on Wednesday, with Gov. Mitt Romney and Senate President Robert Travaglini offering plans to increase Medicaid enrollment and foster more market competition, without raising taxes. The Beacon Hill leaders outlined their plans to business leaders early Wednesday morning.
       Travaglini headlined the Greater Boston Chamber of Commerce breakfast meeting while Romney met privately with members of the Massachusetts Business Roundtable. Further details emerged later in the day when Romney hosted a press conference and filed two bills to implement his plan.
       Travaglini met with privately with industry and business leaders in his
office and plans to file legislation Thursday, when he and other Senate
leaders will host their own press conference. In his speech, Travaglini said the Senate plan will increase reimbursements to health care providers who treat the uninsured by $90 million a year for four years - $45 million of state money to be matched each year by the federal government, create market incentives by making information about health providers more accessible to consumers, and restore the state’s investment to certain prevention programs.
       Sen. Richard Moore (D-Uxbridge), chairman of the Health Care Financing Committee and co-sponsor of Travaglini’s bill, said the state will invest $25 million in programs such as cancer screening and tobacco cessation. Moore said other investments will bring the plan’s total new costs to about $100 million.
       Included in that investment is $3 million in grants for groups assisting in signing up residents eligible for Medicaid. Romney earmarked $250,000 in his budget proposal for next year for marketing outreach programs to enroll as many eligible residents in Medicaid as possible. Today, Romney said the state has added roughly 47,000 new enrollees to the program during the last 12 months.
       Business and health care industry leaders with knowledge of both plans say that where Romney looks to focus on eliminating the uninsured population by 2009, Travaglini’s proposal is a “more comprehensive” plan to reform health care access and affordability.
       “Conceptually, they’re both great,” said Eileen McAnneny, vice president for government affairs at Associated Industries of Massachusetts, after meeting with other business and industry leaders in Travaglini’s office. “As the economy improves, employers offering health insurance are going to be the more attractive option for people looking for work.”
       Experts estimate the state’s uninsured population to be between 450,000 and 650,000. Travaglini believes the figure to be 530,000, and has pledged to reduce that figure by half within two years under his plan.
       “In our view there’s no more pressing issue,” Travaglini told reporters
today after his speech. “The experts have come in and told us what they
perceive to be the appropriate way to proceed. And they’ve made it clear
that we have to offer more affordable plans and we have to change the whole arena. We have to make it far more competitive.”
Both plans also address mandated coverages for insurance companies to offer within available health care plans. Currently, all insurance policies are required to cover more than 25 areas, such as emergency room care, surgery and ambulatory services. The Senate plan would impose a two-year moratorium on any new mandates while a commission studies the current mandates and their economic impact.
       Romney’s Commonwealth Care plan, which would be available to individuals, small companies and other groups, would require certain services be covered, as approved by a nine-member board. Treatments at in vitro fertilization clinics would no longer be covered under the insurance plan, he said.
        The Senate plan will also set up a new Consumer Health Care Costs Board to evaluate and collect data on all health care providers and disseminate that information to consumers. “By providing more information to consumers, we can unleash market forces to help contain costs,” Travaglini said.
       Moore said the plan will also establish a small group advisory board to monitor health care plans being offered to small businesses, and overhaul the Insurance Partnership program, which subsidizes health insurance costs of businesses with up to 50 employees. The Senate plan will expand eligibility to businesses with 75 employees, he said.
       The Senate plan would also include options for consumers to purchase long-term care insurance.
       “We want to make it so attractive that no one will have to go to the
uncompensated care pool,” Moore said, referring to the state-administered “free care” pool that pays those who care for uninsured residents, usually hospitals and community health centers.
       Travaglini said that increasing insurance access and coverage may be
painful given the state’s stagnant economy and the potential of less
financial support from the federal government. “No responsible person
would suggest that we can painlessly fix all of these problems,” he said.
       “Especially at a time when the federal government is plotting to slash
Medicaid to the tune of $60 billion over the next 10 years.”
Health and Human Services Secretary Ronald Preston estimated that roughly $400 million is at risk to be lost from the federal government, which the state uses to reimburse to hospitals that treat the uninsured.
“By July 1, we have to work out certain things to secure that money,” he said.
       Preston said he was hesitant to support a plan that gives providers more money without taking an objective look at the entire system. Increasing reimbursements to providers could result in those providers increasing their rates for consumers, he said.
       “In the business, one has to be careful about just feeding appetites,”
Preston said. “This needs to be a thoughtful and analytical process.”
Preston and his staff, along with staff from the Executive Office of
Administration and Finance, have been developing the administration’s plan for more than two years, Romney said today. The plan would require
insurance companies to develop a scaled-down plan affordable to individuals at roughly half the cost many are currently paying.
       For example, Romney says the Commonwealth Care product would cost between $134 and $160 a month, after taxes, per person, or between $350 and $500 for a family plan. Romney estimates there are roughly 204,000 residents in the state who can currently afford health insurance, but opt not to purchase it or work at a company that does not offer it. Roughly 150,000 residents who Romney believes currently rely on “free care” will be covered by the so-called Safety Net program, which he will introduce this summer.
       Romney also envisions providing between $500 and $1,000 in incentives to businesses that offer the Commonwealth Care product, in part to defray any state fee required to enroll in the program. Those details are still being worked out, Romney said.
       Marylou Buyse, president of the Massachusetts Association of Health Plans, said health insurance companies could produce a product to meet the parameters laid out in Romney’s bill.
       “The cost of health care has become a major barrier to economic growth in Massachusetts and the top reason many employers and their workers give for not purchasing health care coverage is the ever-rising cost of health care,” Buyse said in a statement. “The approach that the Senate president outlined today, including measures to make coverage more affordable through new health insurance options, makes us optimistic about the prospect of real health care reform this session.”
       Through a spokeswoman, House Speaker Salavatore DiMasi said health care reform remains a top priority of the House. Travaglini will join Moore, Senate Ways and Means Committee Chairwoman Therese Murray (D-Plymouth), Community Development and Small Business Committee Co-Chair Sen. Harriette Chandler (D-Worcester), and other Senate leaders at a press conference Thursday at 2:30 pm in the Senate Reading Room to unveil full details of the plan.