Massachusetts Health Insurance Law In The Eyes Of Experts

Massachusettshas made "reasonably good progress" in implementing its universalhealth coverage law, Jon Kingsdale, executive director for the Massachusetts Health Insurance Connector Authority, said Monday at a forum sponsoredby the Alliance for Health Reform and the Kaiser Family Foundation, CQ HealthBeat reports. However, health careexperts at the forum acknowledged that legal, cost and regulatory challengesremain, according to CQ HealthBeat. Under the law, Massachusetts residentsages 18 and older are required to obtain health insurance, if affordable coverageis available, or pay a tax penalty. The state offers subsidized coverage forlow-income residents, and employers also must contribute to the cost ofworkers' coverage or pay into a fund.

Kingsdale said that two-thirds of the 340,000 newly insured state residentshave enrolled in the subsidized program, while the remaining one-third havepurchased private coverage. Kingsdale said that, as a result of the law,premiums for residents who purchase private coverage have declined by nearlyhalf. Meanwhile, costs for the Commonwealth Care subsidized program areincreasing by 6.5% per beneficiary, Kingsdale said. The increase "is belowbudget," but "we've got a lot of challenges," Kingsdale said,adding that "this is a huge financial venture." Commonwealth Carespending is expected to reach $647 million this fiscal year and $869 million inFY 2009. Lawmakers are considering an increase in the state tobacco tax tooffset the unexpected cost.

Grace-Marie Turner of the Galen Institute said that costs to taxpayers areincreasing because of the law. She said that the cost of the program in FY 2009"could be closer to $1.1 billion." Turner said, "The fines Ithink are going to be an issue particularly as they go up." According toTurner, other challenges the law faces include a 12% insurance rate for FY 2009approved for next year and the possibility of "crowd out" of privatecoverage. In addition, Turner said the state's federal Medicaid waiver expiressoon, raising questions about whether the law is "still going to be legalunder Medicaid law" (Reichard, CQ HealthBeat, 5/19).

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