A Healthy Blog

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

US health policy

ERISA Primer (I)

Last week, a federal district judge in Baltimore struck down Maryland's so-called "Wal-Mart tax" on the basis that it violates a federal law called ERISA. Folks who have been in state health policy for a while are quite familiar with this law and its relationship to state health reform. I assume many are not. And because this case and ERISA have real consequence for health reform in Massachusetts, let's a take a moment to review ERISA. (Click here for an excellent summary piece by Pat Butler for the National Academy for State Health Policy. Read more »

Wal-Mart Decision -- Massachusetts Between the Lines

Continuation from previous post ... Judge J. Frederick Motz, US District Judge, makes explicit reference to the new Massachusetts health reform law, in his ruling against the Maryland Wal-Mart tax: "Of course, I am expressing no opinion on whether legislative approaches taken by other States to the problems of health care delivery and its attendant costs would be preempted by ERISA. For example, the Commonwealth of Massachusetts has recently enacted legislation that addresses health care issues comprehensively and in a manner that arguably has only incidental effects upon ERISA plans. Read more »

Baltimore Fed Court Strikes Down Maryland's Wal-Mart Tax

A federal court today invalidated Maryland's mandated health benefits law, otherwise known as the Wal-Mart tax, passed in January over a gubernatorial veto. The law requires employers with more than 10,000 workers to pay at least 8% of payroll on health benefits or pay the difference to the state -- Wal-Mart is the only affected employer of the law. Click here to get the court decision. The decision will almost certainly be appealed by the State of Maryland, and will have many more twists and turns, and may end up at the US Supreme Court. Read more »

Money, Medicine and Reform

On today's Wall Street Journal editorial page, Andy Stern, President of the Service Employees International Union, makes an offer or throws down a gauntlet (take your pick) to America's corporate leaders on the need for thorough national health system reform. Definitely worth a read. Wonder how many CEOs are reading? If they're not reading Andy, I hope they don't miss the revealing piece in today's New York Times (click here) showing medical device manufacturers getting sage advice from hospital CEOs on how to peddle their drugs, devices, and financial services to hospitals. Guess who ends... Read more »

NEJM: Employer-Sponsored Insurance — Riding the Health Care Tiger

This week's New England Journal of Medicine has David Blumenthal's must-read second article on the future of employer sponsored health insurance in the U.S.: "Employer-Sponsored Insurance — Riding the Health Care Tiger." Last week (see July 7th Healthy Blog) provided an historical overview of how we got into this mess. This week's article explores current approaches of employers to rampant health care inflation. Compelling and important reading. Here's David's conclusion: Read more »

I Get Down with the Retailers

Today I traveled to Wentworth by the Sea in New Castle, NH to participate in a panel discussion at the annual conference of the Eastern States Retail Association. Jon Hurst, head of the MA Retailers, invited me. Though Jon and I disagree on loads of things, he’s a first rate advocate for his industry and a terrific guy. And the meeting included reps from key “employer responsibility” battleground states such as Maryland, New York Vermont, Rhode Island and more – about 25 folks in all. Not too shabby a place, and a great schedule for attendees – 3-4 hours of morning meetings followed by... Read more »

When Is a Law Not a Law?

This is just delicious. December 2005, Congress passes and President Bush signs the Deficit Reduction Act, making deep cuts to all kinds of domestic spending while they cut taxes further for the wealthy. The controversial requirement for all Medicaid clients to provide citizenship documentation -- it's all part of DRA. Turns out, due to a Senate typo, the House and Senate did not approve the exactly same bill -- see today's New York Times editorial -- you know, the stuff you learned in 7th grade civics class. No problem -- Speaker Hastert and Senate leaders signed a statement saying it was... Read more »

NEJM on Employer Sponsored Health Insurance

One of the best health policy thinkers in Massachusetts -- and the nation -- is David Blumenthal at Mass. General Hospital's Health Policy Institute. The New England Journal of Medicine this week publishes the first of a two part series on the past and future of employer-sponsored health insurance in the U.S. Whether you know this key part of U.S. health care or not, the article is a must read. Click here to read. Here's this week's conclusion: Read more »

WSJ on "Wal-Mart Tax Fizzle"

Today's Wall Street Journal does an editorial obituary on the so-called Wal-Mart tax movement. In January, the Maryland legislature overrode a gubernatorial veto to enact a requirement on for-profit firms with 10K+ workers (only Walmart) that they must pay at least eight percent of payroll on health benefits or pay the difference to the state. WSJ is correct that no other state has followed this path despite bills filed in 33 states to do so. Read more »

A Peek at the Federal Medicaid Commission’s Directions

Second post from Seattle: Sunday afternoon panel on Medicaid organized by Diane Rowland of the Kaiser Family Foundation. Key speaker? No, not me, Chuck Milligan, respected Medicaid authority from U of Maryland. A federal Bush-appointed Medicaid Reform Commission has been meeting for the better part of a year, raising worries among health care advocates of another program assault. Milligan gave a preview of the Commission’s thinking and directions. Four key efforts, all aimed at the long term care (LTC) side of the program, and frankly, none of them as scary as feared: 1. Enhance State... Read more »


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