Health insurance costs rise again; those with subsidies to pay more
By Alice Dembner, Globe Staff
The state's new subsidized health insurance program will cost "signficantly" more than the $869 million proposed in the governor's FY2009 budget just two months ago, the state's top financial official said today.
The budget gap looms despite steps taken today to hold down state costs -- approval of a tough contract with insurers, and increased premiums and copayments for about half of the 176,000 people enrolled.
"We have closed some of the fiscal gap here, but we have not closed most of it," said Leslie Kirwan, state secretary of administration and finance. She declined to quantify the gap in funding for the Commonwealth Care program, which is at the heart of the state's healthcare reform initiative.
Kirwan said the governor is asking all the powerful players that have supported healthcare reform to contribute to a solution. In the last two weeks, during closed-door meetings, several dozen proposals have been put forward, including raising assessments on insurers, hospitals and businesses.
Healthcare advocates had vehemently opposed the increased premiums and copayments for enrollees, arguing that the insurance would become unaffordable for many and that it was unfair to ask low-income people to contribute more without also asking more of businesses, hospitals and insurers.
The administration muted their criticisms by lowering the increases slightly and by agreeing to seek similar "sacrifices" from other parties.
The premiums will go up 10 percent on average. For example, people with incomes between $21,000 and $26,000 who are now paying $70 per month, will pay $77. Only those with incomes over about $15,000 pay any premiums.
Copayments will rise $5 for a primary-care doctor's visit and between $2.50 to $5 for generic drugs. For enrollees at the highest income levels covered in the program -- those making between $26,000 and $31,000 a year -- copayments for use of the emergency room and for outpatient surgery will also rise. For the first time, there will be caps on out-of-pocket expenses, adjusted by income level.
It's a good thing they can opt out and not have insurance. Oh wait, this is Massachusetts home of the nanny state and "mandatory"health insurance.
It will be interesting to see where the threshold lies for people to find it cheaper to take the hit on their state taxes as "punishment" for not enrolling vs. paying the ever-increasing premiums.
I am so torn between the right (and the associated costs) of all persons to have adequate health care and the right of them to tell you to take your crappy insurance schemes and stuff them.
I want that undocumented worker to get his shots and not come to work sick getting the rest of us poor slobs sick too. But I don't want the agencies involved ripping everyone off in the process.
When you don't have your health you have nothing. Guard yours well, and your pocket book.
The mass healthcare reform was nothing but lies from the start. it make health insurance more expensive for everyone. vote the liberals out!!!!
It should be understood that the increased premiums applies to only about one-quarter of the 176,000. The other three-quarters pay no premiums. And the increased co-pays are for about one-half at the upper end of the income threshold. The other half will pay no more in co-pays.
This was all part of the plan from day 1. Start the costs off low in order to get everyone to buy and then jack up the price every year. It will be to late for anyone to complain or get out by then. I think the penalties are also higher this year too.
A win/win for the insurance companies and the government.
I wonder what the government will do the penalty fines they collect from middle class families who can't afford health insurance after the rate hike.
Should ANYONE be shocked/surprised?? The pols at the statehouse didn't address how the UNEMPLOYED are to pay for this MANDATORY insurance. If you are employed, 99 44/100% of employers have SOME plan, and you work, you can pay. Now get layed off. Ok, for 26 weeks the state pays you 1/5 th your prior earnings, but your mortgage didn't get reduced by 4/5ths, nor did any of your BILLS, or FOOD costs. COBRA? give me a break!! 3/5ths of your state check will go to THAT BILL alone. So, the question is this. If you're employed in Mass, fine...but all bets off if you get layed off - and just how does the state expect layed off victims to pay - and remain non-homeless?? Deval?? Mr Speaker?? can you sleep well at night??
This is what happens when your legislature lets industry largely write the "reform" law (BCBS Roadmap to Coverage project).
Anyone have an update on the MA Attorney General's investigation of the $20 Mil payout by nonprofit BCBS to outgoing CEO Bill VanFaasen?
"These salaries are out of control," said state Sen. Mark Montigny (D-New Bedford). "They don't pass the smell test or the laugh test. These insurers are hiding behind the veil of their not-for-profit status."
Harvard Pilgrim CEO Charles Baker was paid $1.3 million last year and Tufts CEO James Roosevelt got $1.1 million. BCBS paid their CEO Cleve Killingsworth $3.6 million, and had nine other million-dollar pay packages - including base salary, bonus, retirement and health care benefits, parking allowances and other perks - to its top executives in 2007. BCBS politically connected board members rake it in, too. Details at atatathttp://www.bostonherald.com/news/regional/general/view.bg?articleid=1079694
The most important thing hospitals can do to control costs is to improve the safety and quality of care given to patients. By reducing preventable harm to patients, the extra expenses of treating patients for hospital-acquired infections and other such matters will help to reduce costs (while, of course, also helping patients.) At BIDMC and BID~Needham, our governing Boards have committed our hospitals to aggressive targets along this path and to open disclosure of our progress towards these targets. See http://runningahospital.blogspot.com/2008/01/aspirations-for-bidmc-and-bidneedham.html. As Jim Conway at IHI has noted, only when hospitals choose to hold themselves publicly accountable for such results are we likely to see substantial and sustained progress in this realm. I think it is reasonable for people to ask why this has not become the norm for hospitals in the state.
If you want health care to be purely free market driven, then repeal the laws requiring health care providers to give services without first securing payment, including Emergency Room care.
Otherwise, realize that once you mandate that (expensive) services must be provided without securing payment, you've essentially mandated a cost that will have to be covered by the public sector.
Either healthcare is a basic human right who's cost must be efficiently distributed between the public and private sector; or another just another commodity available only to those who can afford it. We can't have it both ways.
Ok.. so like I read this, not being an actuary or antyhing, but I thought: "Do the math Ria," $869,000,000 / 176,000 / 12 and came up with a premium of $411 pmpm. My next thought was "Geez, what can one buy for $411 PMPM in Massachusetts?" My third thought was "no @#$% its going to cost more! - especially in light of the Form 990 numbers for Cleve and company. And then came my final thought: Perhaps BCBS can piggy back onto BCBS-SC's contract in Thailand and India. What a joke.! Will the last capitated physician and hospital administrator to leave Massachusetts please turn out the lights and bring the flag?
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