AMID ALL the many concerns about the national health reform legislation, Massachusetts residents shouldn’t worry just yet about possible conflicts with this state’s successful reform law. Any problems should be manageable if the state’s congressional delegation rides close herd on the bill that emerges.
Massachusetts’ 2006 reform is now serving as a model for the nation. But the reform proposals in Washington diverge in important ways from the state’s plan and could hurt health reform here if lawmakers do not carve out exemptions for Massachusetts. According to the bill approved by the Senate Finance Committee, for example, a family of three earning $45,775 a year would have to pay $362 a month for subsidized insurance. Under the Massachusetts plan, that family pays less than half that amount, just $154 a month, in the state’s subsidized Commonwealth Care program.
Another striking difference between that committee’s bill and the state plan is the power each grants to the exchanges created to oversee insurance offerings for consumers who cannot get coverage from employers, Medicare, or Medicaid. While the Massachusetts Health Insurance Connector Authority can bargain aggressively with insurers on behalf of these consumers, the Senate committee’s exchange would be little more than an online “yellow pages’’ listing of plans that meet very basic requirements. The bill before the House of Representatives would let Massachusetts run its connector independently and not force it to become part of the national exchange.
The differences among the bills and the state’s plan are the focus of a study commissioned by the Blue Cross Blue Shield of Massachusetts Foundation. It provides a timely alert to Massachusetts lawmakers not to let national legislation undercut a state reform that has brought the total of uninsured down to fewer than 3 percent.
There’s an easy fix. The federal government could exempt from its most onerous requirements any state that already covers more than 95 percent of its citizens - a list that includes Massachusetts alone. There is much talk in Washington among reform advocates of not letting the perfect be the enemy of the good. By the same token, a good national plan shouldn’t be the enemy of a state’s better plan.
