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Healthcare group says state must help more

The state isn't yet doing enough to help people of low and moderate incomes afford health insurance, a coalition of advocacy and medical groups told Governor Deval Patrick yesterday.

The Affordable Care Today coalition, which helped secure passage of the state's health insurance law, called for the state to increase subsidies for those with the lowest incomes and to allow people with moderate incomes to opt out of the health insurance requirement if they would have to spend more than 4 percent to 8 percent of their income paying for it.

The governor's spokesman, Kyle Sullivan, said yesterday that Patrick would review the proposal, along with others, as he seeks to strike a "delicate balance."

"He believes we must be ambitious in expanding coverage without imposing financial hardship on those who truly cannot afford health insurance," Sullivan said.

The board that is charged with implementing the law, the Commonwealth Health Insurance Connector, is due to set preliminary rules Thursday on who should be exempted from the law because health insurance would be unaffordable for them.

The Rev. Hurmon Hamilton, pastor of Roxbury Presbyterian Church and president of the Greater Boston Interfaith Organization, said the coalition's proposal would protect those who are most vulnerable financially, while ensuring that about 75 percent of those without insurance would be covered.

"We want to bring people as much healthcare as possible, not squeeze folks as much as possible," Hamilton said.

A proposal last week by another advocacy group, Community Catalyst, suggested that individuals earning less than $30,000 a year be exempt from penalty if they don't get insurance. That group also suggested that people earning between $30,000 and $60,000 be exempt if they had to spend more than 4 percent to 8.5 percent of their income on health insurance.

However, Jonathan Gruber, an economist at the Massachusetts Institute of Technology and a member of the Connector board, presented a report last week that suggested nearly everyone could afford insurance and no broad waivers were needed.

Many observers suggest that finding a workable compromise on this question will make or break public acceptance of the new law.

The coalition proposal suggests that the state provide fully subsidized insurance for people earning up to $15,000 a year, an increase from the current $10,000. In addition, it suggests reducing premiums for those earning $15,000 to $30,000 to 1 percent to 3 percent of income. Individuals earning between $30,000 and $60,000 would be exempt from the requirement to buy insurance at market prices only if the premium and deductible cost more than 4 percent to 8 percent of income, based on a sliding scale, the proposal suggests.

The proposal would add $12 million to $16 million to the cost of state-funded premiums, according to the coalition. It would also probably exempt more people than some policy makers consider feasible to make the law work. 

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