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
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.