Promoted from the comments, regular contributor Abby writes an interesting piece about the movement in Massachusetts to get to universal insurance there via some kind of Medicaid expansion coupled with pay or play. Meanwhile definitely check out the blog written by the guy behind the Health Care for All coalition in the Bay State…..and I know what you’re thinking — they got the Superbowl Champs and the World Series winners, why should they get any more favors:
What Mitt Romney advocates is barely relevant to the debate in Massachusetts. There’s a veto-proof Democratic majority in both houses, and it looks like Romney won’t be running for re-election. He hasn’t officially announced anything yet, but he did write an op-ed saying that he thought that Roe v. Wade should go and abortion policy should be returned to the states. Hardly a popular position in Massachusetts. I haven’t heard much from Romney advocating for Medicaid expansion. His current thing is to require people to buy stripped-down policies.
There is a coalition of groups called MassAct which is trying to expand MassHealth considerably. They are hoping to get the legislature to act, but they are organizing behind a ballot initiative. There are 4 proposals on the table.
Their goals are
*Expanded coverage for low-income individuals and families through MassHealth.*Providing assistance to middle income, working individuals and families to purchase insurance.*Offering assistance to small businesses to help them pay the premiums for their employees.*Requiring employers to either provide health coverage or pay a fee to the state.*Creating a new state quality/cost leadership council
The pay or play thing could be challenged under ERISA, but they are structuring it as a rebate for spending on healthcare, and businesses with annual payroll less than $50K are exempt. They plan to pay for this through the employer assessment and by raising the cigarette tax.
There is some talk of cutting the free care pool assessment on suburban hospitals to get them behind it. They also want to raise the reimbursement rates. The thinking is that the private patients are covering the cost of current MassHealth patients, and that this is driving up the private insurance rates forcing more people into uninsurance.