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

Health Care Market

More Warnings about Low-Cost Health Plans

One week after the Attorney General’s office filed suit against MEGA Life, more examples of the failures of low cost/minimal benefit plans are emerging. Christopher Rowland’s article in today’s Globe details hardships inflicted on subscribers of those plans. High deductibles and copayments, benefit restrictions, and low coverage caps lead to huge medical bills for individuals they “insure.” Worse yet, the failure by MEGA Life agents and its sister plan, Mid-West National Life to disclose plans’ coverage limitations means subscribers don’t know the costs facing them until it’s too late. Read more »

FamsUSA Report: MA Premiums Rose 6.4X Faster than Earnings -- '00 to '06

New report out yesterday from FamiliesUSA -- click here to get full report. Here are press release excerpts: Health care premiums rose an estimated 6.4 times faster than earnings for MA working families from 2000 to 2006. In that six-year period, health care premiums rose by 69.2 percent, while median earnings rose by only 10.7 percent. Among the key findings: For family health coverage provided through the MA workplace, annual health insurance premiums in the 2000-2006 period rose from $7,341 to $12,419—an increase of $5,078, or 69.2 percent. Between 2000 and 2006, the median earnings of... Read more »

Private Market Merger Commission Meeting Cancelled

The Special Commission studying the merger of the non-group and small group insurance markets will not meet this week. The next meeting is scheduled for next Thursday, November 2 from 10 am to noon at the offices of the Division of Insurance. We hope to have a copy of the agenda to post prior to the meeting. Read more »

MEGA (Life) Worries

More MEGA Life concerns were raised by a lawsuit filed by the Attorney General’s office yesterday. Here is today’s Boston Globe article by Chris Rowland about MEGA Life’s alleged illegal practices, including failure to offer mandated benefits, unfair denials of coverage, and failure to explain coverage limits and exclusions. As noted yesterday, Insurance Commissioner Julie Bowler has publicly supported allowing MEGA Life to expand its plan offerings in Massachusetts through the Connector. The AG suit shows why this is a bad idea. Though Bowler says the Division of Insurance will monitor... Read more »

Market Merger Commission Meets with Kingsdale -- We Watch

The Market Merger Commission met Thursday with Jon Kingsdale and Bob Carey of the Connector to discuss decisions the Connector may make affecting the Commission’s study. There were more folks in attendance this week, 15 spectators, and anticipation at what might be revealed. The most active Merger Commission members were there, including Amy Lischko (Commissioner of the Division of Health Care Finance and Policy), who made valuable contributions, particularly when clarification was needed on Chapter 58. The meeting was fascinating, for what Kingsdale and Carey revealed about the Connector’s... Read more »

Leapfrog Names 59 Top US Hospitals -- MA's Got Five of Them

The Leapfrog Group, a business backed coalition that pushes hospitals to improve quality of care, has named 59 participating hospitals to their first Leapfrog Top Hospitals list. Their survey evaluated 1,200 hospitals nationwide to determine the state of health care quality and safety. The survey found that nine in 10 hospitals have policies in place to avoid operations on the wrong part of the body and eight in 10 require prescriptions to be reviewed by a pharmacist before being given to patients. The survey found that nine in 10 hospitals did not meet standards for two high-risk surgeries... Read more »

Primer on Private Health Insurance Regulation

Families USA, the national consumer advocacy organization, has produced a solid primer on private health insurance regulation: Understanding How Health Insurance Premiums Are Regulated. Click here to obtain. The private health insurance market is the next frontier for MA health reform, and this is one solid document to review as we get into this conversation. Lots of good stuff here. Does a nice job placing the Massachusetts insurance regulatory structure in an appropriate national context. Read more »

Market Merger Commission to Meet with Kingsdale and Connector Staff

The Special Commission appointed to study the anticipated effects of the merger of the non-group and small group insurance markets, and the firm they have hired to do the study, have wisely determined that much of their analysis hinges on decisions within the control of the Connector. (What types of products will be offered by the Connector? How expensive will they be? How broadly will the Connector apply the individual mandate, just to name a few.) The merger commission has invited Jon Kingsdale and Bob Carey of the Connector staff to join them for their next meeting, and they have agreed... Read more »

10/12/06 Private Market Merger Commission Meeting: Complexity Galore

If you really want get into health reform – the gory details, the uncertainties, the interrelationships, the guessing how little known provisions may alter drastically the MA insurance market, meetings of the Market Small/Nongroup Market Merger Commission are for you. This is graduate level health reform. They met this past Thursday, 10.12.06 and here are our notes: Read more »

Market Merger Commission Meets Thursday

The Special Commission to Study the Merger of the Nongroup and Small Group Health Insurance Markets will meet tomorrow, Thursday, October 12, 2006 from 10:00 am to 12:00 noon. The meeting will be held at the Division of Insurance at One South Station, Boston. Hearing Room. Go to the fifth floor and proceed directly to Hearing Room B. The purpose of the meeting is to discuss the assumptions going into the study. It should be an interesting and important meeting. Read more »


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