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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