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SPIN: "The mandate will not cost extra money and will not lead to more taxes." TRUTH: The mandated insurance law has created a large, intertwined bureaucracy of numerous new agencies and has cost taxpayers many millions of dollars. Billions more will be budgeted for the future.
It's true that the state is counting on millions being reimbursed by the Federal government, but there
is no certainty, especially given the monetary woes and budget cuts that now make national
headlines on a daily basis |
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expensive undertaking. Of course, it costs taxpayers in others ways as well. Do you think that the 176,307 enrolled in Commonwealth Care in September 2008 or the 165,003 enrolled as of the end of March 2009 - 72% fully subsidized and the remaining 28% highly subsidized in profit-driven health plans - don't cost money that comes out of your taxes? The built-in cost of churn and the Connector's administrative budget of over $39,000,000. for 2009 add to the bill. People also need to understand that there is a 4% to 5% premium added to these plans that is earmarked toward the operations of the Connector. We must also remember that there is approximately 30% non-medical spending in the plans themselves. It also affects important state programs. The FY09 state budget was put together with bubble gum and Band-Aids. Some line items were zeroed out and others showed no appreciable increase at a time when the cost to run them required more funding due to the skyrocketing prices of gas and food such as Meals on Wheels - an important program for our senior population. Governor Patrick made two sets of 9c cuts which included the budget of Boston Medical Center which treats low-income patients and seniors. Other health care centers have also suffered. The prescription coverage program for low-income seniors was also cut. See budget cuts here, here and here. April 2009 showed a decrease of approximately 35% in tax revenues. The state income tax has been increased by 25% and alcohol purchases taxed (as if they weren't already heavily stuffed with taxes.) There is talk of increasing the gas tax by $.19 cents per gallon as well as the state income tax while there could very well be no funding for the program that supports community-based, long-term care for elders and adults with disabilities. There is no funding for the outreach specialists who assist low-income residents with health insurance enrollment and maneuvering this complicated, bureaucratic non-system. Meanwhile billions of dollars were, and still are, designated to prop up this failing health care reform. All Bay Staters as well as citizens across America need to pay attention and understand all of this because the national plan is based on this model, and the drafts and white papers we’ve seen of the Kennedy and Baucus bills aren’t far off the mark. Even President Obama has frequently alluded to the Massachusetts plan.
Everyone also must understand that there is a 4 to 5% premium - charged to the taxpayer and earmarked for the Connector’s operations - on each and every one of the Commonwealth Care and Choice premiums. And, of course, we must remember that there is approximately 30% overhead in the premiums and plans for non-medical spending such as advertising, direct marketing, TV commercials, etc. This is truly the
epitome of our health care sold as a commodity on the marketplace. If you think that you are not affected by this law because you have insurance through your work or on your own, we are all paying dearly for this misbegotten contrivance and will continue to do so until it is halted either legally or by its own demise. As for this being a model for the national plan . . . we’ll let you decide. We see it as a path to disaster leaving millions of Americans in dire straits - worse off than they already are regarding access to affordable, quality health care. |
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SPIN: “Insurance costs will decrease for all residents because the mandate will increase the risk pool” TRUTH:
"Health Insurance to Rise Again Close to 10%" (excerpt from
Commonhealth , September 10th, 2008): Bebinger: The state’s largest insurer, Blue Cross Blue Shield says premiums for most of its customers will rise 8 to 11%, a few points more for small businesses. Senior Vice President for Sales Tim O’Brien says those increases are slightly lower than the projections at this time last year.” Bebinger: “O’Brien says employers who are trimming that 1-2% from the price of health insurance are doing that by asking employees to pay higher deductibles or co-payments, and by adopting programs that help workers improve their health. Jim Klocke, Senior Vice President at the Greater Boston Chamber of Commerce, says few employers will take next year’s rates as good news.” Jon Hurst: “It’s very discouraging; the promise of health care reform clearly has not been felt by small businesses.” Bebinger: “Jon Hurst, President of the Retailers Association of Massachusetts, says covering the uninsured was supposed to help lower insurance rates for everyone. Health Care economists still predict a modest decline, but not anytime soon. Hurst says small businesses, which typically see the largest premium increases, can’t absorb another hike. Also
see
Business balking at health changes and Gov: Biz fees for Mass. health care may rise. |
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SPIN: "The mandate will not increase taxes for insured residents or take away from other important programs. The mandate will only cost $125 million over the next three years and then will pay for itself." TRUTH:
From the New York Times (Apr. 21. 2008): "The state subsidies were budgeted at $472 million for the first year but actually cost $625 million. Only months ago, Mr. Patrick proposed spending $869 million for the coming year, but his aides already acknowledge that will not be enough. The state recently agreed to increase its payments to insurers by 9.4 percent. More costs are being passed along to policyholders in the form of higher premiums and co-payments."
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SPIN: "The Mandate has no effect on those who already have employer sponsored insurance." TRUTH: In order to remain legally acceptable, all health insurance plans must now contain a certain level of benefits and costs sharing limits. This is called "Minimum Creditable Coverage". Hundreds of thousands of residents had plans either through work or privately which did not meet these standards. Pursuant to this law, they were required to upgrade their policies before December 31, 2008. Of course, this cost individuals and employers significantly more while insurance companies profits soared. This Boston Globe article explains more. Those who did not upgrade their coverage were penalized as if they had no insurance at all. Employees whose employer sponsored insurance does not meet MCC are not eligible for Comm. Care. even if their income would otherwise qualify them (from Connector minutes - 6/11/2009 ). In 2007 and 2008, some residents had signed up for a MEGA Life health insurance plan, hoping to meet the individual mandate. While MEGA Life may have one plan that meets Minimal Creditable Coverage standards, the majority of its plans offer far less than is required in Massachusetts, and because insurance salespeople are not required to inform potential members that their plans don’t meet MCC standards unless they are asked directly, all residents who purchased one of the plans that was not state-approved had to pay a penalty as well as paying for the policy until the next open-enrollment period. Many who upgraded to meet the MCC requirements have found that higher premium costs added to the co-payments and deductibles make this mandatory coverage useless. This is often referred to as being "underinsured," meaning, although you are paying for insurance, it costs too much to use. The insurers love this - it’s pure gravy! We have friends, neighbors and relatives who are paying a high monthly premium but can’t afford to seek medical care due to the deductible and co-pays. People with lower incomes and/or health problems are more likely to be underinsured. The Massachusetts mandated insurance law is most certainly not equitable for all nor does it provide affordable health care. The high cost that employers spend to provide even partial assistance for worker's health insurance results in greatly reduced wages and other benefits. See an this article from the Henry J. Kaiser Family Foundation for and excellent discussion of this. On June 12, 2009 the Boston Business Journal reported "Current cost increases for companies renewing the same plan as last year are up between 9 percent and 12 percent at the state’s four largest insurers, according to officials at Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Plan, Tufts Health Plan and Fallon Community Health Plan. In addition, Blue Cross Blue Shield is reporting cost increases of 13 percent to 15 percent for the individual and small group market, which includes small businesses." Employer-based insurance is still seeing huge premium increases as insurers, pressured by the Connector to minimize rates for the state-subsidized Commonwealth Care and its Commonwealth Choice plans pass these costs to businesses. This has a direct effect on the business, hence, the money that must come out of the worker's paycheck. So having insurance through work does not in any way guarantee affordable health care. We all continue to be negatively impacted. |
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SPIN: "The state provides good programs like the "Insurance Partnership", the "Fishing Partnership Health Plan" and the "Qualifying Student Health Insurance Program" to help defray the cost of insurance for select individuals." TRUTH: These state programs are severely limited in population-scope and coverage and residents eligible for FPHP, Tricare and QSHIP are ineligible for Commonwealth Care. These plans all contain "crowd out" provisions. Fishing Partnership Health Plan is limited to those who earn at least 50% of their income from the fishing industry but costs nearly twice as much as Commonwealth Care. Premiums are set annually and based on your previous year’s adjusted gross income. Even if your income is low, you will have to sign up for an FPHP plan. In rare cases, you may be allowed to use the Health Safety Net - catastrophic coverage with no RX or doctor visits - if you can prove to the Connector that you absolutely cannot pay the FPHP premiums. There is also only one provider for FPHP, so you have a limited choice of doctors, care centers and hospitals. Hopefully, who and where isn’t too far from your home or job. Tricare is available to active and retired members of the uniformed services, their families and survivors. There are very strict rules for these plans, and patients are responsible for high deductibles, co-pays and balances over the allowable amounts in some of the plans, especially when there is no military or veteran's hospital nearby and civilian providers must be used. The Qualifying Student Health Insurance Program (QSHIP) is a mandate whereby all full-time and three-quarter-time college students must buy skimpy, school-sponsored insurance. Although these commercial plans are not as expensive as some other insurance, they cost well over $1000 per year and contain very high deductibles, co-pays and coverage limits which can become devastating if a large medical expenditure were to occur. They are also unaffordable to use and leave residents enrolled in these plans underinsured. The "Insurance Partnership", meant to assist in employer payment has very strict rules and is only applicable to very low paid employees and also contains "crowd out" provisions. Although these commercial plans are not as expensive as some other insurance policies, they cost well over $1000.00 per year and contain very high deductibles, co-pays and coverage limits, which can become devastating if a large medical expenditure were to occur. These plans do need to meet the Minimum Creditable Coverage standards as discussed above and can lead to massive medical debt. |
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