Federal Overhaul Will Require Mass To Adjust its Health Reform Law

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Although the 2006 Massachusetts health reform law contains many of the same  provisions as the federal health reform law, state officials must make changes  to comply with federal overhaul standards, Politico reports.

About the Massachusetts Law

The Massachusetts law was signed by GOP presidential candidate Mitt Romney  when he was governor.

Among the provisions that both laws have in common are:

  • A health insurance exchange;
  • An individual mandate;
  • A requirement that insurers cover all individuals regardless of pre-existing  conditions; and
  • Tax subsidies to help people pay for insurance.

Working Out the Differences

Despite the similarities, Massachusetts officials are working on  consolidating key differences between the state and federal laws.

For example, the Massachusetts mandate levies higher fines than the federal  law for people who do not have health insurance. State officials must decide  whether to lower the state penalty or make residents pay both the state penalty  and the federal penalty. According to Politico, lowering the state  penalty would decrease state revenue.

Another difference is that Massachusetts grants fewer tax subsidies to  low-income residents than the federal overhaul. The state’s Commonwealth Care  program provides subsidies to residents with incomes below 300% of the federal  poverty level, while the federal law gives less-generous subsidies to people  with incomes up to 400% of the federal poverty level.

State officials said they will have to decide whether to try to get  Commonwealth Care grandfathered in at its current rate to comply the federal  overhaul.

In addition, some residents currently covered by Commonwealth Care will  qualify for Medicaid in 2014, when the program expands under the federal law. If  those residents leave Commonwealth Care and enroll in Medicaid, it could cause  significant financial problems.

Massachusetts Health and Human Services recently said that membership in the  state’s insurance exchange, called the Health Connector, could decrease by 70%  after the Medicaid expansion, raising questions about the exchange’s ability to  fund itself. Although state officials have said Commonwealth Care will remain  part of the Connector, some analysts are doubtful about the program’s  future.

Josh Archambault, health policy director at the conservative Pioneer  Institute, said, “My view is that the [federal law] kills the Commonwealth Care  program.” He said health stakeholders in the state believe “the Connector should  be scared about future power and market share” under the federal overhaul.  Archambault noted that the Connector “will look very, very different once all is  said and done.”

However, Glen Shor, executive director of the Connector, said, “We have a  great foundation to work off of, and will be very busy in the coming weeks and  months. But I am very confident we will get there” by 2014 (Nocera,  Politico, 1/30).

U.S. Residents Uninformed About Mass. Reform Law, Poll  Finds

A new Harris Interactive poll found that most respondents did  not know about the content and aim of the Massachusetts reform law, the  Washington Post‘s “WonkBlog” reports.

According to the poll:

  • Fewer than 33% of respondents knew the Massachusetts law contains an  individual mandate;
  • Fewer than 25% knew that most Massachusetts residents have health insurance  under the law;
  • About 66% of respondents said they were “not sure” if the law was  successful; and
  • 62% of respondents either agreed or strongly agreed with the statement, “The  Massachusetts health care bill is similar to the bill passed by Congress and  signed by President Obama” (Kliff, “WonkBlog,” Washington Post,  1/30).

Also seen in California Healthline.