Thousands face delay in healthcare enrollment
More than 100,000 uninsured workers will be unable to sign up for subsidized health coverage on the Oct. 1 start date promised in the state's new health insurance law.
A state official said there hasn't been enough time since the law passed in April to create and adequately market the new health plans. He said enrollment would probably be delayed three months.
The delay is the first indication of how difficult it will be for Governor Mitt Romney's administration to meet the Legislature's aggressive goal that all Massachusetts residents have health insurance by July 1, 2007.
The landmark law requires the state to offer low-cost, subsidized health plans by Oct. 1 for about 200,000 uninsured residents who earn up to 300 percent of the federal poverty level -- $60,012 for a family of four. But Jon Kingsdale, head of the authority that is implementing the law, said in a status report filed with the Legislature yesterday that the authority would be ready to enroll only the poorest residents -- those who earn less than 100 percent of the poverty level, $20,004 for a family of four.
That means those who earn more -- about 105,000 people -- will have to wait to purchase subsidized health insurance, probably until Jan. 1, he said.
``We are bound and determined to start enrollment by Oct. 1, and we're rolling out the program for the most vulnerable population first," said Kingsdale, executive director of the Commonwealth Health Insurance Connector.
Selling the new plans to uninsured workers who earn less than 100 percent of the poverty level should be relatively simple. The state will pay their entire premiums, and this group will be responsible for minimal copayments for doctors' visits and other care. The plans will cover only the workers; their children are covered by Medicaid .
But signing up those who earn more than 100 percent of the poverty level is far more complicated. The state will subsidize the premiums for this group, but those with higher incomes will pay significant portions of their premiums and higher copayments, and the connector will have to come up with a substantial marketing campaign to convince this group of the benefits.
A key issue is whether these plans will be affordable, and the Commonwealth Connector still must decide on the amount of the premiums and of the state subsidies. If the authority rules the plans are not affordable for certain individuals, even with the subsidies, those people do not have to buy insurance. In the coming weeks, the authority must define what's affordable, and provide this information to health plans, which then must create specific coverage rules and contract with doctors and hospitals.
Kingsdale said the authority could not do all this, and hold a hearing to solicit public input on what's affordable, by Oct. 1
Several members of the authority's board said the deadline in the law was not reasonable.
``I didn't appreciate until I was involved in this process how crazy the timeline is," said Jonathan Gruber, an MIT economist who advised the governor and House members on health reform and is now on the Commonwealth Connector board. ``I don't think it impacts our ability to get all of the pieces in place by July 1, 2007."
A key legislative leader, Senator Richard T. Moore, Democrat of Uxbridge and cochairman of the Joint Committee on Health Care Financing, met with Kingsdale yesterday and said the delay is not a serious problem. He said the authority does not need formal approval from the Legislature to delay enrollment.
``We wanted to keep everyone's deadlines tight to push them," he said. ``If we can do this by the end of the year, that's reasonable."
John McDonough, executive director of Health Care for All, said the delay ``is not a cause for alarm."
