November 2005

November 30, 2005

Our pals at Associated Industries of Massachusetts -- nice folks, really -- oppose the health insurance payroll assessment passed by the House of Reps in early November. They have created a calculator to let businesses assess what it would or would not cost them if the assessment were enacted and implemented. Click here if you would like to try it out.

Of course, there are a few salient aspects of the House plan left out of the AIM calculator. For example, every business in Massachusetts that provides health insurance to workers pays a portion of an annual $160 million assessment to fund the state's Free Care Pool. The House plan -- unlike Gov. Romney's or the Senate's plan -- eliminates this unfair assessment, providing real annual savings for every such business in Massachusetts. No ability in the AIM calculator to measure this real benefit to Massachusetts employers who cover their workers.

Geesh, can't figure out why they would leave this important detail out.

November 29, 2005

Some embellishments to the entry on the State House News Service poll showing support for the House-approved payroll assessment on employers who don't cover their workers. The overall result -- 66 to 29% in favor. Looking at the poll internals, no big surprises by age, gender, geography, or education. Here's the eye popper -- partisan support:

Democrats -- 71%
Independents -- 66%
Republicans -- 59%

That's right, 59% of Republicans support the payroll assessment on employers who don't cover their workers. Take that, Mitt Romney and every member of the House Republican caucus, all of whom voted against the assessment.

By our count, this is the fourth survey over the past three years that has tested Massachusetts public opinion on this issue. The range in support -- 62 to 76%.

October, 2003 -- Harvard School of Public Health survey shows 76% of MA residents support a mandate on employers to provide insurance coverage.
March, 2005 -- Tom Kiley poll shows 65% of voters support tax on businesses that don't cover their workers.
September 2005 -- State House News Service poll shows 62% support a payroll tax on employers and a new cigarette tax to finance health expansion.

November 25, 2005

Respected pollster Gerry Cherinsky just released a new poll with lots of surprising and significant results, for example:

--Massachusetts voters support in-state tuition rates for children of illegal immigrants 54-42%;
--Gov. Romney's favorability is now at 47%; 42% consider his job performance excellent or above average and 53% label it below average or poor;
--Lt. Gov. Kerry Healey's favorability is at 32%, 33% unfavorable, 37% no opinion;
--AG Tom Reilly beats Healey 57 to 25%, and Deval Patrick scores an easy win also;
--The public is dead split on slot machines at race tracks: 49% yes, and 45% no.

OK, but what about requiring employers to who don't offer health insurance to pay a payroll assessment?

From State House News Service: "The notion of raising taxes on businesses who can afford to provide health coverage, but don't, earned overwhelming support: 66 to 29 percent. But Chervinsky cautioned: "Citizens almost always embrace business taxes without realizing the direct impact that has on them personally. One of the problems with sampling public opinion is that people are inclined to say, 'Sure go ahead, tax 'em,' without taking into account all the implications. The citizenry is a little unrealistic.'"

C'mon Gerry, how about just a little respect? Last April, Tom Kiley did a poll for the Mass. Hospital Association showing that 65% of the public supports payroll taxes on employers who don't provide health insurance to their workers. Why is the health insurance result the only one you feel obligated to diss?

Whatever happens in the legislature and conference committee to the House approved payroll assessment (approved by a comfortable veto proof margin), let's agree right now on one clear fact -- the public agrees with it and supports it.

November 24, 2005

A column in today's New York Times makes the compelling observation: Sometimes, a tax cut for the wealthy can hurt the wealthy. The column lists a litany of ways that our national budget insanity -- cutting taxes for the wealthy and services and programs for everyone -- boomerangs back to hurt the affluent as well. It's written by Cornell's Robert Frank, who has co-written an economics textbook with the Bush nominee to head the Federal Reserve, Ben Bernanke.

Wonder if Bernanke and Frank ever talk about this stuff?

"A careful reading of the evidence suggests that even the wealthy have been made worse off, on balance, by recent tax cuts. The private benefits of these cuts have been much smaller, and their indirect costs much larger, than many recipients appear to have anticipated. ...

"...deficits have led to cuts in federal financing for basic scientific research, even as the United States' share of global patents granted continues to decline. Such cuts threaten the very basis of our long-term economic prosperity. As Senator Pete Domenici, Republican of New Mexico, said: "We thought we'd keep the high-end jobs, and others would take the low-end jobs. We're now on track to a second-rate economy and a second-rate country."

"Moralists often urge the wealthy to imagine how easily their lives could have turned out differently, to adopt a more forgiving posture toward those less prosperous. But top earners might also wish to consider evidence that their own families would have been better off, in purely practical terms, had it not been for the tax cuts of recent years."

Have a happy Thanksgiving everyone.

November 23, 2005

It's just after 5pm and all ballot initiative signatures are now due at city and town halls. The deadline has passed. MassACT, the health reform ballot initiative collected more than 112,000 signatures from nearly every city and town in the Commonwealth. 65,825 certified signatures are required to quality. As of 4pm, the Secretary of State's Office -- which compiles overall results via computer from city and town halls -- indicates that our total number of certified signatures is -- 64,585. We are quite confident we're well over the mark, but we'll have to wait until Monday for that official confirmation.

Don't bite your nails on this one -- bite into turkey (unless you're a vegetarian -- in which case, bite into tofu). Happy Thanksgiving to all our fellow bloggers, blogger viewers, correspondents, and occasional visitors. We've been doing this since April 1 of this year, and it's been an immensely interesting and educational process. Thanks to all of you for helping us along in so many ways.

November 23, 2005

Last week, Illinois announced the implementation of a new comprehensive health coverage program for all children in the state, regardless of income. According to IL state officials, their program, “All Kids,” will make Illinois the first state to provide health coverage for every child in the state.

Sound familiar? Well, not to be picky, but Massachusetts made a credible claim to cross this threshold back in 1996. The devil’s in the details, so let’s explore.

In Massachusetts, any child who can’t get coverage through an employer based plan has one of two options. If the child is a citizen or qualified immigrant, he or she is eligible for MassHealth up to 200 percent of the federal poverty line (about $38K for a family of 4). If the child is ineligible for MassHealth (either because the child is over-income or because of immigration status), he or she is guaranteed enrollment in the Children’s Medical Security Plan. Granted, CMSP has a lot of limitations on eyeglasses, mental health, substance abuse and doesn’t pay for hospital care. So it’s not what folks would consider full insurance. Still it’s a heck of lot better than uninsurance, especially for kids' primary and preventive services. It’s a legit question – does CMSP count as insurance coverage? We say yes.

By the way, we still have about 54,000 uninsured kids in Massachusetts – not because there’s no coverage available; only because the parents have not enrolled their kids. And it’s one of the lowest rates of uninsured kids in the country.

By contrast, Illinois has 253,000 uninsured kids – a much longer bridge to cross. Illinois’ “All Kids” will have a more comprehensive benefits package than CMSP. As opposed to CMSP, All Kids includes hospital stays, though it also imposes waiting periods – periods of uninsurance – on enrollees to discourage families from dropping private options in favor of the new state program. Like Massachusetts, Illinois will probably find that it is unable to enroll every single eligible child, and will show a residual child uninsured population, even after full implementation.

While Massachusetts can rightfully claim to be the first to cover all kids, Illinois is legitimately the first to offer comprehensive coverage for all kids. The current Massachusetts health reform process is likely to result in more fully insured kids as both House and Senate plans increase kids’ eligibility for MassHealth from 200 to 300%FPL.

The Illinois expansion reminds us there is always more to be done for our own kids here in Massachusetts.

November 22, 2005

HCFA, Health Law Advocates, and the Mass. Law Reform Institute are putting Governor Mitt Romney on notice: reinstate dental services for poor pregnant women and mothers or face a lawsuit.

In July, Governor Romney signed the fiscal year 2006 state budget with a legislative mandate to reinstate MassHealth dental services for pregnant women and mothers with children up to age three. After four and one half months of inaction, we are threatening legal action if the Administration drags its feet any longer.

In a letter to Governor Romney sent today, we asked Gov. Romney to “implement the legislature’s mandate to restore dental coverage to eligible women promptly to avoid legal action.”

Our demand letter describes the acute discomfort of a young pregnant mother who has been denied dental care required by law. "One of my clients, who is both pregnant and has a child under age three, has had two teeth pulled since July for lack of comprehensive dental coverage. Failing to provide basic dental care to pregnant women and new mothers is putting both the women and their newborns and toddlers at risk," wrote MLRI attorney Victoria Pulos.

“Implementing this legislatively mandated coverage is a straightforward administrative process’” notes HLA attorney Leslie Storm. “If the state does not comply with the law by December 6, 2005, we will file a civil action on behalf of Health Care For All and all mothers who are affected.”

November 21, 2005

From our friends at Families USA: (The Massachusetts delegation voted 100% the right way, against cuts to Medicaid. Say "thanks" if you have the chance.)

After a long, heated debated, the House approved a budget reconciliation bill early Friday with deep cuts to Medicaid and other social programs. The final vote was close: 217-215. No Democrats voted for the bill, but 14 Republicans voted against it. You can also thank your Rep by sending an e-mail through the FUSA site.

While we are disappointed, we are pleased so many moderate Republicans voted against this budget. It was due to your calls and e-mails—along with thousands from across the country—that made this a difficult vote for the House leadership.

Now the process moves to Conference Committee, where negotiators from the House and Senate will try to find a compromise between the two versions and send it to both houses for up-or-down votes. Because of the close votes (the Senate passed its version by 52-47) and the significant differences between the bills on Medicaid, we believe we have a chance to prevail in this phase. Our best chance lies once again in the Senate.

We need you to call your Senators and urge them to vote NO on any budget that hurts Medicaid recipients. Our toll-free number is up and running: Call your Senators toll-free:1-800-828-0498. The fight to save Medicaid isn’t over yet—it's just entered a new phase, and we can still prevail. With your help, we can do it!

November 20, 2005

The evidence of a national meltdown in employer sponsored health insurance continues to mount. Here's a piece from last week's Providence Journal (11/17):

The percentage of Rhode Island employers that offer health insurance to employees decreased from 79% to 75% between 1999 and 2005, and the percentage of employers that pay full premium for individual coverage declined over the same period, according to a new survey released by the state Department of Health and Human Services. The survey included responses from 1,444 for-profit, not-for-profit and government employers.

The survey found that 65% of respondents with 3 to 10 employees offer insurance, compared with almost all respondents with more than 100. About 71% of "low-wage" respondents -- those who pay more than half of their employees $21,000 or less annually -- offer health insurance, compared with 99% of other respondents. The percentage of full-time employees eligible for insurance at employers that offer coverage decreased from 92% to 87% between 1999 and 2005. Gov. Donald Carcieri (R) called the results "a huge concern," adding that health insurance "is becoming a significant obstacle to economic development and to job growth in the Ocean State."

November 18, 2005

Vote Now: Boston Business Journal: Log-on and vote on SURVEY QUESTION: Should businesses be required to offer health insurance? Right now it is 56% Yes and 41% No. By the way, the question could be worded better. The House plan does not mandate that businesses offer insurance – it requires employers who don’t cover their workers to pay an assessment to the state – far less than the cost of providing insurance – that can be used to finance affordable coverage. Vote Now!

Update from State House News (yesterday): Travaglini said work on legislation to increase access to affordable health care is also not being driven solely by a deadline, despite a letter this fall from the federal government urging lawmakers to show significant progress on health care reform by Jan. 15, 2006 or risk losing federal money. “I am being driven primarily by getting it right,” Travaglini said. “I’m not so preoccupied with the date that that occurs. If it occurs quickly, I’d be as happy as anybody. If it takes a little longer, I’m willing to do that.” In the waning minutes of formal sessions for this year, the House and Senate Wednesday night adopted orders to return for a special formal session to consider health care legislation if a conference committee completes its work. Travaglini said the Senate remains “mindful” of the Jan. 15 date and will try to respond in an “appropriate way.” “We understand that there’s only so much time,” he said. “I’d rather get it done sooner than later because then you have time to fix what needs to be fixed. I don’t like doing things rush, rush in the last minute. That’s when you seem to make mistakes, and the potential for making mistakes is heightened.”

Coming Event: Brookline Chamber of Commerce To Host Panel Discussion on Healthcare
Business Breakfast Series to highlight the rising cost of healthcare and its effects on individuals, businesses and the economy. On Tuesday December 6 the Brookline Chamber of Commerce will continue its Business Breakfast Series with a program that will include a panel of experts in an informative and lively discussion on the timely topic of rising cost of healthcare. Coolidge Corner Theater, 290 Harvard Street (at Beacon St.) Brookline MA.. Registration: 7:30 AM
Continental Breakfast: 7:45 AM – 8:15 AM Program: 8:15 AM – 9:15 AM; 617-739-1330
Mike Widmer (Massachusetts Taxpayers Foundation), John McDonough (HCFA), and Jay Curley (BCBS) on the panel.

November 17, 2005

House and Senate have appointed their respective members of the House/Senate Conference Committee (CC) to reconcile big differences between the health reform bills passed earlier this month in both chambers. For the uninitiated, CCs always have 6 members -- 3 House/3 Senate, two Ds and one R from each chamber. Final report must be signed by at least 2 members from each branch. Report then gets up or down vote in each chamber -- report is unamendable. If voted down by either branch, House and Senate leaders can form a new conference committee to try again -- I've never seen that happen in more than 25 years of watching.

Health Reform Conferees:
Senate Chair: Sen. Richard Moore (D-Bellingham, Blackstone, Douglas, Dudley, Hopedale, Mendon, Milford, Millville, Northbridge, Oxford, Southbridge, Sutton, Uxbridge, Webster) 617-722-1420
Sen. Therese Murray (D-Barnstable, Bourne, Falmouth, Kingston, Pembroke, Plymouth, Sandwich) 617-722-1481
Sen. Brian Lees (R-Belchertown, East Longmeadow, Grandby, Hampden, Longmeadow, Ludlow, Springfield Wilbraham) 617-722-1291
House Chair: Rep. Patricia Walrath (D-Bolton, Hudson, Maynard, Stow) 617-722-2430
Rep. Ronald Mariano (D-Holbrook, Quincy, Weymouth) 617-722-2220
Rep. Robert Hargraves (R-Ayer, Dunstable, Groton, Pepperell, Townsend) 617-722-2430

A few observations: House conferees do not include the Ways and Means Chair Bob DeLeo, opting for Financial Services Chair Ron Mariano, while the Senate Conferees do include W&M Chair Therese Murray as vice chair. This indicates Murray's keener interest and history in the topic. Here's a switch -- Sen. Moore is lead defender of the Senate bill which does not include the employer assessment on businesses; and Sen. Moore is also the lead Senate sponsor of the Health Access and Affordability Act (HAAA) which included an employer assessment; Rep. Walrath will be lead defender of the House employer assessment and was not an original sponsor of the HAAA.

Timing -- they could reach a deal anytime, though most observers think this will go at least until mid-December, quite possibly into January, maybe into February or later, though that's considered unlikely. The key federal official -- Dennis Smith of the Centers for Medicare and Medicaid Services (CMS) -- asked the state to have a plan connected with the renewal of $700 million in federal dollars to them by January 15th. That's considered a soft, not a hard, deadline, though the Commonwealth is taking chances if they let this deadline slide too much. Check out my September 30 blog if you want to read the actual Smith letter.

Today's Boston Globe has an article about a Cape Cod restaurant owner who fears the employer assessment in the House reform bill. What's missing from the story is any attempt to nail down what the assessment would actually cost the owner beyond the phrase "hundreds of dollars a month".

Coming Attraction -- tomorrow morning at 10am the WBUR (90.9) program, On Point, will host a discussion on the Massachusetts health reform controversy. I may or may not be on it -- but please listen and call in if you are so motivated.

November 16, 2005

Is there a better interviewer on Boston television than Jim Braude on NECN's Newsnight at 8:30pm?

Last night, Braude grilled Gov. Mitt Romney on many topics, first among them health reform. Three times Braude asked the Guv if it was fair that employers who provide health insurance to their workers have to subsidize other workers and their employers who don't offer coverage. Three times the Guv dodged the question and tried to change the subject.

The night before, Braude interviewed Speaker Sal DiMasi and gave him a fair working over on the soft spots in the House plan. DiMasi gave as good as he got, and the exchange was provocative, fast-paced, smart, and interesting.

Click here if you want to see either or both interviews. Cheers to Jim Braude for lifting the intelligence level of Boston television.