Volume 18, No. 3, Summer 2010
By Senate President Therese Murray
We have stopped the economic freefall brought on by the global recession, and we are now seeing positive signs of recovery. But there is still more to be done, and that involves creating jobs.
Earlier this year, I authored legislation to improve our business development efforts in Massachusetts, which the Senate passed in April, but we also need to focus on controlling the cost of healthcare for small businesses and individuals to promote job growth.
In March, I laid out a plan to relieve small business health insurance costs and reform long-term healthcare. The Senate has passed this legislation that would spur economic growth by providing small businesses the immediate healthcare cost relief they need to retain and create jobs and start hiring again.
This comprehensive legislation establishes efficiency requirements, addresses the current instability in the market, reduces year-to-year premium fluctuations, and ensures that health insurance carriers offer affordable products to small businesses.
The bill introduces new requirements for health insurance companies to ensure that premium dollars are spent on actual care, not administrative costs such as marketing, salaries or profit margins.
Under this legislation, insurance carriers would file premium rates with the Division of Insurance prior to their effective date for review. Carriers also would have the option of filing rates under an Efficiency Guarantee if they agree that not less than 90 percent of premium dollars will be spent on medical services.
The bill also addresses the underlying drivers of market instability by closing existing loopholes and making technical changes to the oversight of the market.
For example, this legislation ensures that individuals are purchasing insurance in appropriate, ongoing arrangements through an annual open enrollment process and accessing employer-sponsored coverage. This would stop certain people who purchase insurance only for expensive treatments and then drop the coverage, which drives up premiums for everyone.
The bill also requires carriers in the small group market to offer at least one reduced network plan with premiums that are at least 10 percent lower than the full network product.
By requiring more affordable products this year, small business employers can immediately reduce costs while maintaining a high-quality health insurance product for employees.
Additionally, this legislation introduces a product called Business Express Plus which allows eligible small businesses to receive an annual 5 percent subsidy if they participate in a wellness program.
Overall, we estimate immediate premium relief of 10-to-15 percent with the possibility of more for small businesses to save and reinvest.
As I write this, this legislation is before the House of Representatives. And as we continue to push for the short-term solutions contained in that legislation, the Senate is simultaneously working on proposals to address the main drivers of healthcare cost growth over the long term for all businesses, families and individuals.
Ongoing payment reform measures that my office is working on with Secretary of Health and Human Services Dr. JudyAnn Bigby would transform the Commonwealth’s healthcare system from a fee-for-service model into an efficient, effective, patient-centered delivery system.
As we continue to work on these complicated, long-term healthcare solutions, we must seize on the opportunity now to stabilize costs for small businesses, improve our economic development model and create jobs.
(Senator Murray represents the Plymouth and Barnstable District. For more information, visit www.ThereseMurray.com.)
By Senator Rob O’Leary
Look closely at those video images from the Gulf Coast as we struggle to deal with that cataclysmic oil spill.
We see the damage to the waters and to the fishing and tourism industries. We see the forlorn oil-coated water fowl. But then, look again. See the workers struggling to contain and capture the spill. That’s protective gear they’re wearing, including rubber gloves and inhalators to protect their lungs. Yes, these spills—whether from drilling accidents or tanker disasters—can be hazardous to human health…and not just to the workers out there on the water or the shore.
Who knows what health problems will surface in the future from fumes wafting ashore? And already we have reports of a spike in cases of mental illness from residents unable to cope with the loss in lives and livelihood and the degradation of a once-pristine environment.
Can it happen here?
Well, we don’t have drilling, but we do have tankers plying our waters. And, fortunately, here in Massachusetts I am proud of the work we have accomplished in leading the nation to protect ourselves.
A major legislative accomplishment that I worked on with my Senate colleagues that now seems particularly relevant was the Buzzards Bay Oil Spill Protection Act.
In 2003 a horrific oil spill from a Bouchard tanker released upwards of 98,000 gallons into Buzzards Bay.
In response, the state conducted a major review of existing regulations. Working with local groups, legislators, and emergency responders they determined that there were a number of holes in state laws regarding oil carriers and responses. In 2004, An Act Relative to Oil Spill Prevention and Response in Buzzards Bay and the Other Harbors and Bays of the Commonwealth, was signed into law by Governor Mitt Romney.
This legislation raised fines for oil spills, implemented new safety standards, changed navigational rules including tug escort pilotage requirements and Massachusetts Pilots licenses for Buzzards Bay, and also imposed a two-cent per barrel fee to establish a $10 million fund for state and local oil spill response and training.
In light of the recent BP Gulf oil leak, we need to ask ourselves, why do we need to have hundreds of thousands of gallons of oil shipped to our shores, or pumped off our coastlines every day? The 2004 oil spill protection act was a major step forward for Massachusetts. But we live in an interconnected world and what happens off the coast of Maine or North Carolina or Louisiana can affect our coasts.
That is why we need to take a look at how we use energy. No matter how much legislation is passed or how many billions of dollars oil companies have to pay once a disaster of this magnitude occurs, as long as we continue to increase our reliance on fossil fuels, we run the risk of recreating these environmental crises.
Without lifestyle changes, situations like the oil leak in the Gulf of Mexico or the oil spill in Buzzards Bay will always be a risk. We owe it to ourselves and future generations to begin reducing our dependence on fossil fuels. For our health and for the health of the environment.
(Senator O’Leary, D-Cummaquid, represents the Mid and Lower Cape and Islands and is a member of the Legislature’s Joint Public Health Committee.)
By Representative Cleon H. Turner
Since the passing of the 2006 statewide Health Care Reform legislation, Massachusetts has been in the forefront of innovative approaches to the healthcare problems facing our citizens. Now, in seeking to make similar changes on a national scale, the federal 2010 Patient Protection and Affordable Care Act will affect the existing Massachusetts healthcare system by supporting and expanding health insurance programs that are already in place and working well within the Commonwealth.
Most of us will not see changes right away, as Massachusetts already has many of the consumer protections that now will be federal law. For example, Massachusetts, insurers already cannot deny coverage to people with preexisting medical conditions.
One immediate benefit of the federal reform would be the decrease in cost to over 102,000 small businesses in Massachusetts who pay 18 percent more, on average, than large business to cover employees. Under the new legislation, these businesses will be entitled to tax credits by which small employers can elect a tax credit for half of their employee health care coverage expenses.
Massachusetts will see an increase in funding for Medicaid, Commonwealth Care, and MassHealth. Federal funding for Massachusetts’ Medicaid and Commonwealth Care programs will increase by nearly $5 billion between 2014 and 2020 and additional federal assistance, $2.3 billion, will be provided to pay for MassHealth in 2014.
Medicare will now provide an annual wellness visit that includes a risk assessment and a 5-to10-year personalized prevention plan with no co-payment or deductible. A special fund appropriated from 2010 through 2014 will allocate $10 million to continue the Aging and Disability Resource Center Initiatives.
A common question is “How will my Commonwealth Choice coverage change?” As long as you purchased a commercial health insurance plan through the “Choice” program, your coverage will continue without change. The federal law was written to avoid any disruption to existing coverage. If you cannot afford health insurance, keep in mind that Massachusetts helps income-eligible people to obtain such coverage. Starting this year, people with incomes up to 400 percent of the federal poverty level will qualify for subsidies.
Though both sets of laws are complex, it is important that everyone fully understand how they will affect us all so we can act as educated consumers. We’re fortunate that information is abundant. For the most up-to-date and accurate data about Federal Health Reform, browse www.healthreform.gov or call my office at 617-722-2090.
(Representative Turner, D-Brewster/Dennis/Yarmouth, is a member of the Legislature’s Joint Public Health Committee.)