A Healthy Blog

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

National Health Reform

Happy Fiscal New Year! House, Senate Send FY 2014 Budget to Governor, With Some Good News for MassHealth Dental Coverage

Today the House and Senate sent to the Governor the FY 2014 budget (giant pdf), which  was filed by the joint conference committee late last night. Any minute now, we'll get a detailed report from our friends at the Mass Budget and Policy Center, and we'll post a link and any updates as they do their analysis. (Update: their analysis is here) But we were smiling when we turned first to the Medicaid line items. Smiling, of course, because the final budget includes $17.2 million to restore coverage for dental fillings for adults in the MassHealth program. These funds should allow the MassHealth... Read more »

Senate Takes Up ACA Bill Today

The Massachusetts state Senate is planning to vote today on legislation to implement the Affordable Care Act in Massachusetts. The bill (H. 3452) was approved by the Senate Ways and Means Committee yesterday. The Committee recommended several technical amendments, and one curious symbolic amendment that purports to address a lingering, bogus issue that apparently cannot be put to rest. Read more »

House Passes ACA Bill

Today the Massachusetts House of Representatives passed legislation required to implement the ACA. The bill passed on a 116-32 vote that was almost all along party lines. Every Republican voted no, and all but two Democrats voted in favor of the bill. The vote was preceded by a spirited, if somewhat misguided, debate. Rep. Jeffrey Sanchez, chair of the Public Health Committee, began the debate by emphasizing that the ACA would improve coverage by building on our earlier expansions, and save money for state taxpayers: "We’ve been innovators here in this building, and everyone is looking at us... Read more »

ACA Bill Advances in Massachusetts House

Today the state House of Representatives gave preliminary approval to Governor Patrick's legislation to implement the ACA in Massachusetts. The bill, H. 3452 (text, section-by-section (pdf), and topical summary (pdf)), is expected to come up for a final House vote on Wednesday. Read more »

ACA Drives Cumberland Farms To Expand Coverage. Result: "Shockwaves Throughout the Industry"

The Framingham-based company that owns the Cumberland Farms convenience store chain and all Northeast Gulf gas stations just announced a smart, reasonable step that will be seen as bold, and confounds conventional wisdom about implementation of the ACA. Effective January 1, 2014, the Affordable Care Act requires that full-time employees working at a company with at least 50 workers have access to affordable health insurance through their employer. Full-time is defined as working 30 hours a week or more. If the company chooses not to offer full-time employees affordable health coverage, the... Read more »

About Last Night's Question

HCFA is a 501(c)3, so we don't endorse candidates or take positions on partisan electoral issues. So we need to be careful in our commentary on last night's debate between Senate candidates Gabriel Gomez and Ed Markey, including their answers to a question about health care (watch it). So here's a topic we can have a strong opinion on: the question itself. Here it is, asked by Boston Globe political editor Cynthia Needham: Read more »

Senate Budget Debate Starts Wednesday - Here's Our Amendment Recommendations

Tomorrow the state Senate will begin debating its version of the state budget for fiscal year 2014, which begins on July 1. Like the House budget did, the Senate Ways and Means version starts out with a strong commitment to building on the state's health coverage reforms through implementation of the ACA, and some substantial deficiencies in funding for health care programs. The best overview of the Senate budget comes, of course, from the Mass Budget and Policy Center. The overview notes the continued decline in support for public health: Read more »

More Building Blocks For ACA Implementation

While ACA implementation remains contentious in many states, in Massachusetts the building blocks are being set in place in a routine and orderly way. On Wednesday, MassHealth released its revised ACA implementation plan, called the "Roadmap to 2014." Also released was the state's proposal to the federal CMS for an extension of our Medicaid waiver, along with supporting documents (the materials can be found on the MassHealth waiver documents webpage). Read more »

Brouhaha Good News Update: De-Merger Averted; Tobacco Surcharge Rejected

Several weeks ago we posted on the controversy over implementing ACA rules on insurance regulations. It can get complex, but the short summary is that when Chapter 58 merged the individual and small group health insurance markets, Massachusetts allowed insurers to offer discounts to the larger small groups. The discounts are matched by surcharges added to premiums paid by individuals and smaller small groups. So larger small groups (typically companies with 35-50 workers) pay less than they should, and individuals and small firms pay more than they should. The spread resulted in the winners... Read more »

What's all this brouhaha? Small group insurance premiums controversy erupts

Last Tuesday's Globe lead editorial ("Mass. needs an Obamacare waiver for small-business health plans") looked at an arcane issue that has turned into a big deal for some small business associations in Massachusetts. If you just read the editorial, or coverage in the business press (sample: Massachusetts health care costs out of control as ObamaCare provision hits small business, from Boston Business Journal), one would think that some horrible provision of the ACA is leading to increased health costs in Massachusetts. What's going on here? Aren't we the blueprint for Obamacare? Read more »


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