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A Healthy Blog

Massachusetts health care – wonky with a dose of reality

April 1, 2005

Welcome to HCFA's blog. We'll do this 3-5 times weekly, touching on anything related to MA health policy. For starters, let's see where health reform in Massachusetts is at right now.

Last November, health care access hit the front pages big time with announcements by Sen. Pres. Bob Travaglini and Gov. Mitt Romney that they want to eliminate or reduce substantially the number of MA uninsured, estimated between 460,000 and 650,000 residents. In December, the MA Health Reform Coalition -- with HCFA in the lead -- filed reform (the Health Access and Affordability Act-- lead sponsors: Sen. Dick Moore and Rep. Debbie Blumer) legislation. Since then, the issue dropped off the media radar screen.

The issue is ready to re-emerge. Next week, we expect Pres. Travaglini to release a plan, and we hear Gov. Romney's staff is working furiously on their own. So, most likely by late April, there will be three major proposals -- all of which will be referred to the new Joint Committee on Health Care Financing, chaired by Sen. Moore and Rep. Patricia Walrath. Among the three, there will be similarities and striking differences. Gov. Romney's will be a "market based" approach offering a scaled down insurance plan he hopes the uninsured will voluntarily purchase. The MHRC approach includes expansion of MassHealth for lower income and a "health care minimum wage" to help all working uninsured persons get coverage. Sen. Travaglini's plan, we believe, will be in the middle.

Also at play:

In January, the state and federal governments agreed on a plan to continue a "waiver" under which Massachusetts operates our Medicaid program, preserving $600 million in vital extra payments. Key details are unresolved, and the state may yet lose a big chunk of the money, with drastic consequences for health access reform . The new waiver takes effect, for better or worse, on July 1, 2005.

Also, the Blue Cross Access Foundationcontinues work with the Urban Institute on its "roadmap" plan for universal coverage due for a final release in the fall.

And the MHRC this summer will file a ballot petition for placement on the November 2006 state ballot with the requirement to collect more than 65,000 signatures between early September and mid-November 2005 to give voters a chance to weigh in.

What's it all add to? A thick policy and political stew with much left to do. Will reform happen in 2005? Maybe, and there's a chance to achieve real progress in the FY06 budget process this spring, making downpayments on access, provider rates, and more. Experience teaches us that it will take the House and Senate a lot of time to get their arms and minds around this complex area, and we expect major legislative action to occur between January and July 2006. That's how it looks to us right now.

Please use the form at the bottom to add your own thoughts and ideas. We'll use some of the best comments in a future column. And let us know how to make this blog better.