The Massachusetts Health Plan: How Did They Do It?

On April 4, the Massachusetts legislature approved a plan that requires all adults to purchase health insurance by July 2007, or face a fine. The plan is projected to expand coverage to 95 percent of the state’s uninsured residents over the next three years.

Like many other states, Massachusetts has struggled during the last decade to devise mechanisms that can bridge coverage gaps between public sector programs and the private sector. State legislators, the governor, and interested stakeholders decided to focus on the responsibility of individuals to purchase health insurance, as well as to highlight the important role of employers in helping to finance and organize coverage.

The result is a hybrid plan that features an individual mandate, and which also subsidizes coverage for those whose income is below 300 percent of the federal poverty level ($49,800 for a family of three, and $60,000 for a family of four). Some rules for the insurance market have also been rewritten by the state to merge the non-group and small group markets, with the expectation that this change could reduce premiums by an estimated 25 percent.

How did Massachusetts craft such a far-reaching plan with bipartisan support? What do health care providers, consumers and businesses think of the plan? What are the prospects that other states might adopt certain features of the Massachusetts experience?

To discuss these and related questions, the Alliance for Health Reform and the Kaiser Family Foundation sponsored a May 8, 2006 briefing. Panelists were: Edmund Haislmaier, research fellow at the Center for Health Policy Studies at the Heritage Foundation; Tim Murphy, secretary, Executive Office of Health and Human Services in Massachusetts; and James Mongan, president and CEO of Boston-based health system Partners HealthCare. Diane Rowland of Kaiser and Ed Howard of the Alliance moderated the discussion.

Transcript

Full Transcript (Adobe Acrobat PDF)

Speaker Presentations

Tim Murphy Presentation (Adobe Acrobat PDF)
James Mongan Presentation (Adobe Acrobat PDF)