KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Massachusetts’ Individual Mandates, Insurance Exchanges Are Examples For National Plan

"Three years into its experiment with near-universal health care, Massachusetts has some 'dos and don'ts' for the nation as it grapples with the best way to cover tens of millions of uninsured Americans," the Associated Press reports. "Do require that virtually everyone have health insurance, the overriding goal in Massachusetts. Don't ignore rising costs, the single greatest threat to the law's long-term affordability."

Massachusetts' 2006 health overhaul has increased the percentage of residents with insurance from 94 to 97 percent by requiring individuals to buy insurance and expanding subsidies to for the poor, but: "costs to the state have been climbing, thousands have paid tax penalties for being uninsured, and some of the newly insured are struggling to find doctors."

When the overhaul was enacted, "the budget for Commonwealth Care, the subsidized insurance, soared from $472 million to $628 million as the uninsured flooded into the program faster then anticipated." Now, the state government is overextended. Critics say not addressing costs from the beginning was a mistake that the nation should avoid. To make up for lost time, "Massachusetts is now weighing a change in the system it uses to pay doctors, so they would be rewarded for keeping patients healthy, not performing more tests" (LeBlanc, 7/24).

PBS' the NewsHour: "Massachusetts has proved a testing ground for a concept that could emerge as a centerpiece to national health care reform: a health insurance exchange." Insurance plans are subject to minimum standards and the state runs an insurance exchange called "the Connector."

"[T]he Connector is, at its most basic, simply a marketplace where people can buy health insurance. But that marketplace can be organized in many different ways, can be given different amounts of authority, and can be open to all consumers or only to select groups. Right now, Congress is debating the shape of a possible national health insurance exchange -- with bills in the House and Senate proposing somewhat different possibilities. Proponents of a strong health insurance exchange say that structured properly, an exchange could help stimulate competition among insurers, cut costs and increase enrollment in insurance plans" (Winerman, 7/23).

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