Keep health reform moving
IN JULY 2006, US Health and Human Services Secretary Michael Leavitt praised the Massachusetts health insurance plan as a national model. He was in Boston then to announce the extension of the special Medicaid funding that enabled Massachusetts to expand coverage to nearly everyone. Leavitt needs to quickly extend this money, which is available through a waiver of Medicare rules, so that the state's landmark initiative can continue.
Governor Patrick is meeting with Leavitt tomorrow to discuss renewal of the waiver, which expires June 30. Patrick might recall the words of his predecessor, Republican Mitt Romney, who told Leavitt in 2006: "Massachusetts is now at the forefront of a revolution in the way we think about healthcare." He added, "The reforms we crafted bring coverage to all our citizens."
Romney was indulging in a bit of hyperbole. The state hasn't managed to cover everybody, but a study by the Washington-based Urban Institute found that 93 percent of the working population had health insurance as of last fall. Sharon Long, researcher on the study, figures that if children and the elderly are included, the total insured population in Massachusetts exceeded 95 percent, an extraordinary figure given that the national rate was about 84 percent in 2006, the year with the latest Census figures.
"None of us should expect perfection here," Leavitt said in 2006. "Mistakes are going to be made."
The Legislature has provided an adequate share of money. The new healthcare connector authority has created subsidized coverage for those just above the poverty line. Private companies have written policies for these people, and for those who can afford unsubsidized insurance. The experiment has gone well, with one exception: The state underestimated the number of people who would enroll in subsidized plans.
It's unclear how much money is involved in the waiver renewal negotiations, but the amount is sure to exceed the $625 million annual federal contribution under the current plan. The governor and Legislature are ready to provide money to accommodate extra enrollment, but they need help.
Many people contributed to the passage of the healthcare law in 2006, notably Romney, Leavitt, and his predecessor Tommy Thompson - all Republicans - along with Senator Edward M. Kennedy and the Democratic legislative leadership. Leavitt said then that "every component of our society" needs to contribute to providing access to affordable, basic healthcare. Massachusetts has shown it can be done. The Bush administration, led by Leavitt, needs to help maintain progress toward this bipartisan goal.
