Health Reform: How Much Does It Cost & How Is It Financed?
Last Friday's Globe had a letter to the editor from BI/Deaconess' Dr. Richard Parker concluding: "... I am waiting for some straight talk on the numbers." Reasonable question -- wonder why the mainstream media has not added light to this. Healthy Blog puts out the numbers as we understand them (hope this prints out OK -- forgive the mess if it occurs):
|Federal Safey Net Revenue||605.0||610.5||610.5|
|Federal Medicaid Match||184.6||242.1||299.6|
|Free Rider Surcharge||50.0||40.0||25.0|
|Fair Share Assessment||45.0||36.0||22.5|
|MCO Supplemental Funding||287.0||180.0||160.0|
|Free Care Pool/Safety Net Fund||610.0||500.0||320.0|
|Children to 300%||18.2||27.4||37.4|
|Restored MassHealth Benefits||48.0||53.0||58.0|
|Medicaid Rate Increase||90.0||180.0||270.0|
|Commonwealth Care Subsidies||160.0||400.0||725.0|
|Three Year Balance||+116.4||+33.2||-167.9|
Major question from Dr. Parker -- how does the $295 employer assessment pay for this big health reform package. Answer -- it doesn't. It's a small part of a large package and the major source of money each year is federal.
Bigger question -- how does this hold up? Our sense -- passes the laugh test, plausible and tight. Likely to turn out as planned? Not likely -- prepare for surprises, pleasant and unpleasant. That's life in this territory. What's important now -- strong commitment by House and Senate leaders to make it work -- real political commitment to meet the promises outlined in the soon-to-be new law. Up to all of us to hold them to it.