Paul Wilczynski's Observations

Massachusetts Quality Affordable Health Care Act

Because my church is a member of the Greater Boston Interfaith Organization, I attended a meeting a few nights ago to learn about the MassACT! Campaign – a ballot initiative in Massachusetts for affordable health care.

If you’re a resident of Massachusetts and are interested in health care reform, they’re looking for your help and the help of members of your congregation.

Below is a summary of the law they’re proposing. If you’d like to help, please call Lisa Vinikoor at 617-275-2807 or contact her via email at vinikoor@massact.org. They're having meetings right now and are planning a signature collecting campaign for September.

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Section-by-Section Summary
Massachusetts Quality Affordable Health Care Act
SECTION 1: Policies and Purposes

• Outlines the current health care crisis.


• States the Act’s intention to increase access to affordable health insurance coverage for all Massachusetts residents.

SECTION 2: Establishing the Quality Affordable Health Care Program to assist small businesses and moderate income families with health care costs

• Creates the Massachusetts Quality Affordable Health Care program to assist moderate income families and small businesses with their health care costs. Uninsured individuals below 400% of the poverty line ($38,000 for an individual) will be eligible for the program.


• Authorizes increased eligibility in the Insurance Partnership, an insurance reimbursement program that helps small businesses provide health coverage.


• Allows the Executive Office of Health and Human Services to implement a targeted reinsurance program to lower premiums for small businesses and individuals. The reinsurance pool would cover individuals with catastrophic medical costs, allowing insurers to cut premiums.


• Authorizes sliding-scale premium reductions or tax credits for middle income households up to 400% of the federal poverty level.

SECTION 3: Affordable Health Care Fund

• Establishes the Affordable Health Care Fund, which will be used to finance the Massachusetts Quality Affordable Health Care program and the expansion of MassHealth eligibility and benefits.  


• The Fund will consist of revenues from the increased cigarette tax, the assessments on businesses that do not provide health coverage to their employees, and federal reimbursements.

SECTION 4: Expanding coverage for low income working adults and children

• Authorizes MassHealth to cover all adults up to 200% of the federal poverty level ($19,000 for an individual) and children under the age of 21 up to 300% of the federal poverty level ($58,000 for a family of 4).

SECTION 5: Lowering health care premiums by repealing the Uncompensated Care Surcharge paid by insurers and other health care purchasers

• Repeals the $160 million Uncompensated Care Surcharge now paid by insurers and employers who purchase health coverage for their employees.  

SECTION 6: Lowering health care costs by reducing the Uncompensated Care Surcharge paid by hospitals [not included in versions C and D]

• Limits the hospital sector’s Uncompensated Care Surcharge to $80,000,000, which is half of its current level.

SECTION 7: Cigarette tax earmarked to fund affordable health care programs

• Raises the cigarette tax 60 cents per pack, to $2.11.


• All revenues will be deposited into the Affordable Health Care Fund.

SECTION 8: Affordable Health Care Fair Share Assessments

• Creates an Affordable Health Care Fair Share assessment to ensure that all employers are contributing to their employees’ health care costs.


• For employers with more than 100 workers, the assessment is 7 per cent of their adjusted payroll.


• For employers with 100 or fewer workers, the assessment is 5 per cent of their adjusted payroll.


• The first $50,000 of an employer’s annual payroll is not assessed.


• Money that employers already spend on health insurance benefits for employees will be considered a credit against this assessment.  Thus companies covering their workers will not pay the assessment.


• The regulations enforcing these provisions will include exemptions for substantial hardship.


• Revenues will be deposited into the Affordable Health Care Fund.

     
SECTION 9: Restoring MassHealth benefits and eligibility

• Restores benefits which were in effect in January 2002, including:


• dental services and dentures


• eyeglasses


• Adds smoking and tobacco use cessation treatment and information to the MassHealth benefit package


• All residents who are lawfully residing in the United States are eligible for benefits on the same terms as citizens.

SECTION 10: MassHealth payment rates shall cover costs [not included in versions B and D]

• Directs MassHealth to pay hospitals, community health centers and physicians their costs for serving MassHealth recipients.


• Directs MassHealth to use the Medicare payment system in reimbursing hospitals and physicians.

SECTION 11: Severability

• Declares that if any section of this law or an application of it is deemed invalid, the invalidation will only affect that specific section.  

SECTION 12: Effective Dates

• The cigarette tax increase takes effect on January 1, 2007.


• The employer assessments take effect on July 1, 2007.


• The MassHealth payment reforms take effect on October 1, 2007.

posted by Paul Wilczynski @ 7:25 PM