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National health reform could have unintended consequences for Massachusetts and other early reform states, State Senate committee states

July 22, 2009 ... Could a National Health Reform Law prove costly to Massachusetts? That is the question being raised by a Special Senate Committee on National Health Reform. The national proposal being pushed in Congress by President Barack Obama is largely modeled on the success of the landmark Massachusetts health reform law passed in 2006, as well as a companion effort to improve health quality and contain rising health costs, which was approved by the state legislature last year. The Committee Chairman, Sen. Richard T. Moore, D-Uxbridge, was among the architects of health reform in Massachusetts.

In a recent report entitled, "A Law of Unintended Consequences? National Health Reform and Its Impact on Health Reform in Massachusetts," the Committee cites a number of features of the Massachusetts health law and encourages the federal government to adopt these same, or similar, features in its national plan. In light of this, the report goes on to raise a number of important concerns, mostly about suggestions that have been proposed to help fund the national reform effort, which could prove very expensive for the Bay State.

Additionally, some of the proposals fail to help states like Massachusetts, that have led the way on health reform with increased funding, to sustain their bold efforts at providing virtually universal health care for their residents.

The Senate Committee’s conclusions are based on testimony from numerous experts and stakeholders in Massachusetts who have been key advocates of health reform on the local level. Some of the leaders include Senate President Therese Murray, D-Plymouth; Dr. JudyAnn Bigby, Executive Office of Human Health and Services Secretary; Rosemarie Day, the Deputy Director of the Commonwealth Health Insurance Connector Authority; Dr. Mario Motta, President of the Massachusetts Medical Society; Amy Whitcomb Slemmer, Executive Director of Health Care For All; Eric Schultz, President & CEO of Fallon Community Health Plan; Michael Widmer, President of the Massachusetts Taxpayer’s Foundation; Beth Piknick, President of the Massachusetts Nurses Association; and Dr. James T. Mongan, President & CEO of Partners HealthCare System, Inc.

The report details some major points of concern of the Committee, which include:

• Medicaid Expansion Maintenance of Effort – states that have expanded Medicaid enrollment or eligibility could be penalized for early efforts;

• Medicaid Match Reduction – states with up to a 50% floor of federal matches would be penalized if the floor is further reduced;

• Concern That Level of Payments To Providers Be High Enough – payments higher than Medicare or Medicaid rates attract and retain primary care providers;

• Creditable Coverage – state requirements for minimum health insurance coverage and mandated benefits should be respected;

• Insurance Regulation – state regulation and licensing of insurance plans should not be pre-empted;

• Support for Graduate Medical Education Needs to Continue – states with medical schools and tertiary care clinical facilities would be harmed by elimination of federal support. It would undermine efforts to expand primary care providers;

• The Need for Federal Matches for Legal Aliens

• The Need to Address Medical Malpractice – the major factor in the practice of defensive medicine.

View the full report by clicking here.

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