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Key Elements of Mass. HealthCare Reform. Jon Kingsdale Bipartisan Congressional Health Policy Conference January 13, 2007. Programmatic Elements. Subsidized premiums (Commonwealth Care) Individual mandate Incentives for employer participation (>10) -S. 125 plans

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key elements of mass healthcare reform

Key Elements of Mass. HealthCare Reform

Jon Kingsdale

Bipartisan Congressional Health Policy Conference January 13, 2007

programmatic elements
Programmatic Elements
  • Subsidized premiums(Commonwealth Care)
  • Individual mandate
  • Incentives for employer participation (>10)-S. 125 plans

-”Fair & Reasonable” contribution

  • Market reform (Commonwealth Choice)
  • Enhanced Medicaid payments
a relatively small problem
A Relatively Small Problem

MA Population 6.2 million

Insured 5.8 million

Uninsured 372,000

≤ 300% of FPL 140,000

>300% of FPL 160,000

Other 70,000

political recipe for reform
Political Recipe for Reform
  • Lots of money already in the “system”
  • Well organized, funded & respected advocacy
  • Bi-partisan commitment to health care reform
  • Provider and insurer support for reform
  • $385 mm federal carrot/stick
  • Business acquiescence (“culture of reform”)
hcr 5 years in the making
2003Governor,BCBSMA,& ACT commit

11/04Roadmap to Coverage Sen. Pres. commits

2/051-year extension of federal waiver

3-6/05Governor’s Plan

Sen. Pres’ bill

Governor’s bills

11/05Speaker’s bill

4/06Enactment

7/1/06 Medicaid expansion

1/1/07 C-Care implemented

7/1/07 Individual mandate Employer assessment Non-discrimination

C-Choice

10/1/07 UCP re-write

1/1/08Real mandate in effect

HCR: 5 years in the making
progress to date
Progress to Date
  • Commonwealth Care for adults < 100% FPL
      • October 1, 2006 start date
      • Target population of ~60,000
      • 50,000 individuals confirmed eligible
      • 40,000 enrolled in health plans
  • Commonwealth Care for adults 100% to 300% FPL
      • January 1, 2007 start date
      • Target population of ~80,000
market reform
Market Reform
  • Create credible, non-group risk pool
  • Merge small- & non-group rating
  • Expand product options
  • Create a new market for choice (Commonwealth Choice)
commonwealth choice

Non-offeredIndividuals

Non-workingIndividuals

SmallBusinesses

SoleProprietors

Commonwealth Choice

Commonwealth Connector

MMCOs

Blue CrossBlue Shield

Tufts

NHP

Harvard Pilgrim

Health NewEngland

Fallon

commonwealth choice s value proposition
Commonwealth Choice’s Value Proposition
  • Individual choice
  • Administrative simplicity
  • Pre-tax premium payment
  • Portability of coverage