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Statement by Senator Moore in response to Governor Romney’s proposed health plan

Goal: 

In his “State of the Commonwealth Address,” Governor Romney announced that he wants to make Massachusetts the first state to provide access to health insurance for all of its citizens. That means providing access for the estimated 460,000 – 700,000 uninsured Massachusetts residents while keeping the rest of the population insured. The Senate shares that goal and, in fact, the Senate President has declared as a priority for the 2005-2006 session to reduce the ranks of the uninsured by half in the next two years. We plan to work with the Administration and the House toward that goal, and it will take the full commitment of everyone over the next few years.

My Concerns: 

The Governor says there are 106,000 citizens who qualify for, but are not enrolled in Medicaid. What are we doing today to enroll these 106,000 individuals and families? Mass Health Essential was recently capped at 36,000, with a waiting list. We are also facing the loss of federal funding for safety net hospitals. Both problems run counter to plans to reduce the uninsured and must be addressed or the number of Medicaid eligible uninsured will surely grow.

The Governor says that the Medical Security Trust (MST) contributes to insurance costs for those who are unemployed for 30 weeks of insurance coverage. He says there are 36,000 who are unemployed and some newly employed whose health benefits have not yet begun. He proposed that the MST could be used to purchase his new “Commonwealth Care” plan. He will need legislation for such a change. At the same time, in his proposals to reform Unemployment Compensation, he has proposed cutting back the benefits to 26 weeks in order to reduce the cost of UI. This would reduce the funding available under the MST as well. Unless the MST covers all or most of the health insurance cost, the unemployed or newly employed might find it hard to afford even “Commonwealth Care.” 

The Governor says we can create affordable insurance called “Commonwealth Care” modeled on a similar plan in New York State which subsidizes health costs over $5,000. We need to cover about 168,000. But the Governor doesn’t want to increase state funding. What funds will be used to subsidize this program and to pay for needed outreach? Healthy New York has, so far, been unsuccessful, only serving 74,000 out of 3 million uninsured, and New York subsidizes the plan with state funds of $13 million last year and $49 million this year. 

The Governor proposes to work with the Legislature to develop “Safety Net Care” to replace the Uncompensated Care Pool for the remaining 150,000. The concept is to manage care through a network of clinics, community health centers, and hospitals directing people to the most effective and efficient care through health centers. The problem with this concept is that the Administration’s policies such as cutting funding for hospitals and health centers as he proposed last year or withholding funds appropriated in the current budget for distressed hospitals will make it hard to provide services. Furthermore, a proposal to reduce drug payments to community health centers that could force the centers to close discount pharmacies that the Administration urged them to open, or close the centers all together. 

Conclusion:

Addressing the issue of expanded coverage will cost more money for the state as well as for those now without insurance who, in many cases, would be asked to contribute co-pays or deductibles. We must also help to ease the growing financial burden for the majority of individuals, families and businesses who have been paying for insurance all along. If the Governor doesn’t want to increase total spending, but maintains his commitment to reducing revenues, what major program or benefit cuts will be made in order to provide the needed new funding to expand health coverage? Health care case management and new technology will clearly save money in the future, but investments in the management of care, in outreach to promote new programs, and in the needed technology must first be made. That will take additional resources and real reform, not just lofty goals expressed in catchy slogans, to achieve the goal of full health coverage.

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