Massachusetts Health Plan Model

Here are the main points of the Massachusetts Health Plan. Senator Obamas plan is thought to mirror the approach described below.

Legislators say by that by providing every Massachusetts resident with health insurance, the costs of health care are actually lowered. For instance, the way the system works now, employers who offer insurance also have to pick up part of the tab for the cost of care for the uninsured at hospitals. By having more employers provide insurance, and having fewer uninsured people, these costs to employers go down. Analysts also say that adding more healthy people -- who use less care -- into the insurance system keeps deductibles and premiums down for all.

A look at how the bill would affect employers and individuals:

All individuals must have coverage.
-- Those below 300 percent of the federal poverty level (about $38,500 for a family of three), but not eligible for Medicaid, will have their private insurance plans subsidized at a sliding-scale rate. -- Children whose families earn below 300 percent of the federal poverty level (FPL) will be given free coverage through Medicaid.
-- Individuals with incomes below the FPL ($9,600) will have premiums waived on private insurance. (Currently most childless adults are not eligible for coverage under the state's Medicaid plan.) -- Those who can afford insurance will be increasingly penalized for not buying coverage. In the first year, they'll lose their state personal income tax exemption.
-- Family coverage will be extended to cover young adults up to the age of 25.
-- Allows the use of "health savings accounts" with cheaper high-deductible "catastrophic" coverage plans. HSAs allow consumers to invest money and withdraw it "tax free" to cover health-care costs. BusinessesAll employers who have more than 10 employees must contribute to employee health-care costs.
-- Employers who don't provide insurance will pay an annual fee of $295 per full-time employee.
-- Encourages private insurers to offer more low-cost options.
-- Creates a "health insurance connector" to help individuals and businesses find affordable private coverage.

Health Insurance Mandates Unhealthy

Health insurance costs are rising faster than Massachusetts businesses can afford and still, MA policymakers are considering measures that would push them even higher.

The House will consider a bill that would mandate unlimited coverage of mental health services, even though Massachusetts’ current mandate is among the most generous of any state in the nation.

Already, Massachusetts ranks among the states with the most mandated health benefits. While a case can be made for any one mandate, together they add significantly to the cost of health care.

When health insurance costs go up, employers bear the bulk of the increase, which leaves less money for companies to grow their businesses and create new jobs. This is particularly true for small businesses.

With health-care costs continuing to rise at double-digit rates, solutions need to focus on controlling those costs, not piling up more costs on employers.

Universal Health Insurance Massachusetts

The nation's first law requiring people to maintain health insurance faces its biggest test: Will the remaining 375,000 or so uninsured residents of Massachusetts buy health insurance policies?

Signs of the state's push for people to buy health insurance coverage are everywhere.

The pressure is on because the number of uninsured who sign up is key to the law's success: If large numbers of people flout the law, premiums could rise faster in future years, and the goal of cutting the number of uninsured to near zero would be lost.

Sunday marked a largely symbolic but important deadline — the date when nearly everyone in Massachusetts was required to have health insurance coverage, whether through their jobs, on their own (individual health insurance) or through a new program offering subsidized health coverage to low-income residents.

Requirements that residents buy health insurance are being proposed elsewhere: Republican California Gov. Arnold Schwarzenegger has promoted it as part of his health insurance plan, as has Democratic presidential hopeful John Edwards. Another presidential contender, Sen. Barack Obama, D-Ill., has said parents should be required to carry health insurance for their kids. Republican Mitt Romney, also running for the presidential nomination, helped get Massachusetts' mandate passed in April 2006, when he was the state's governor.

Mandated Health Insurance Prices set

Health insurance plans with monthly costs of $122 to more than $800 were approved Thursday by the board overseeing Massachusetts' new law requiring everyone in the state to carry health insurance.

The lowest health plan premiums will be paid by young adults, ages 19 to 26; the highest, by those over 55. The least costly premium for those in the middle is about $175 a month. The state aims to cover all uninsured, with subsidies for those below 300% of the federal poverty level, which is about $30,000 for an individual.

Health Insurance in Massachusetts

Massachusetts Commonwealth Care -has enrolled nearly 45,000 MA residents into its individual health insurance plan as of Feb. 1, 2007.

Commonwealth Care is a subsidized health insurance plan for individuals who meet certain eligibility requirements and whose income is below 300 percent of the Federal Poverty Level.

health insurance coverage via the plan include: doctor office visits, inpatient hospital care, pharmacy benefits, mental health and substance abuse services, and vision. Members in Plan Type 1 also receive dental care. There is no monthly premium for Plan Type 1, and members in Plan Types 2, 3 and 4 have sliding premiums based on income. All members must pay a fee (co-payment) for some benefits.

The Commonwealth Care Health Insurance Plan (Commonwealth Care) is a program run by the Commonwealth Health Insurance Connector Authority (the Connector). This program connects eligible Massachusetts residents with approved health insurance plans and helps them pay for the plans.

The Connector helps Commonwealth Care members join a health plan and find providers that meet their needs. A health plan works together with a certain group of providers, hospitals, and other health care professionals to provide specific health-care services.

Commonwealth Care pays the total cost of health insurance for qualified individuals who have income at or below the federal poverty level and helps pay for the cost of insurance for other qualified individuals.

Minimum Health Insurance Requirements

The board charged with getting Health insurance Companies to come up with affordable health care plans will consider a proposal that would allow health insurers to offer health plans that don’t include prescription drug coverage.
The goal is to encourage health plans that offer solid health coverage and also affordable by anyone earning at least three times the poverty rate.

A key sticking point has been whether those healthcare plans should require drug coverage.
Health Insurers say drug coverage would drive up monthly premiumsand make the goals unattainable. Health care advocates say drug coverage should be a key part of any health insurance plan.