A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

House Advances Short-Term Small Group Cost Control Bill

House Advances Short-Term Small Group Cost Control Bill

July 21, 2010

UPDATE: HCFA also supports the provisions that restrict unfair contracting practices (those enumerated in s. 36 of the bill) and simplify the administration of health benefits.

Controlling the growth in health care costs is the most important challenge facing Massachusetts. It is critical to balancing our state budget and stabilizing local budgets. Increasing insurance premiums are breaking the budgets of small businesses and stifling employers’ abilities to increase wages, hire new workers and expand our state’s economy. For individuals, the galloping cost of coverage prices too many out of the market for insurance.

On Tuesday the House released its version of legislation to ease health care premium growth for small businesses and individuals. Amendments will be filed on Wednesday, the bill is scheduled for debate on Thursday.  These short-term actions are important first steps. We hope this legislation brings us one step closer to comprehensive payment reform. Only by reorienting our health payment and delivery system around patient needs, rewarding wellness and prevention, can we achieve real savings and improve quality.

HCFA supports the initiatives in the House bill that strengthen accountability for costs at the provider and the insurer level.  We applaud the establishment of wellness programs similar to that being implemented by the GIC under the authority of the Connector and the Department of Public Health, oversight of provider rates so that payments are more equitable, and increased reporting on quality so that we can begin to link payments to health care outcomes. HCFA also supports the provisions that restrict unfair contracting practices and simplify the administration of health benefits.

HCFA strongly opposes sections 38, 40 and 41, which would increase prices for small businesses by weakening the Health Connector Authority.  These provisions would add a broker representative to the Connector Board (section 38), would not allow the Connector to require carriers in the individual market to participate in the Connector's group market (section 40), and would prohibit the Connector from working with DOR to promote its products (section 41). The Health Connector is a critical part of the solution to small business and individual health care cost containment. The Health Connector Board has worked hard to find a broad consensus when faced with difficulty issues. The current board is fairly balanced, and the legislature should not upset a well-working agency.

HCFA also strongly opposes sections 14-16, the so-called “drug coupon” provisions.  This only facilitates expensive brand-drug marketing, raising costs for through increased utilization of new to market, higher cost prescription drugs.

Small group insurance market reforms are important short-term solutions.  However, they are just the beginning of the discussion on health care cost containment.  Next session must include work on comprehensive payment reform, which will move our system to rewarding quality care that promotes health and prevention. We believe payment reform is vital to moving towards lasting affordable coverage.

-Georgia Maheras