Clip files / Local news from the states
This column features selected short items about state health care policy.
Massachusetts' subsidized care plan's cost to double
BOSTONThe subsidized insurance program at the heart of Massachusetts' healthcare initiative is expected to roughly double in size and expense over the next three years, an unexpected level of growth that could cost state taxpayers hundreds of millions of dollars or force the state to scale back its ambitions.
State projections obtained by the Boston Globe show the program reaching 342,000 people and $1.35 billion in annual expenses by June 2011. Those figures would far outstrip the original plans for the Commonwealth Care program, largely because state officials underestimated the number of uninsured residents. The state has asked the federal government to shoulder roughly half of the program's cost from 2009 through 2011, but there is no guarantee of that funding.
Commonwealth Care provides free or subsidized insurance for low- and moderate-income residents. "The state alone cannot support that kind of spending increase," said Michael Widmer, president of the Massachusetts Tax- payers Foundation, a business-funded budget watchdog group. Even with federal backing, the state may not be able to afford the insurance initiative as designed, because the law did not make any attempt to trim wasteful health spending, said Alan Sager, a Boston University professor who specializes in healthcare costs.
Currently, 169,000 people have enrolled in the program, which is expected to cost $618 million in the fiscal year ending June 30. When it authorized the program in 2006, the legislature estimated that about 215,000 people would eventually be enrolled at a cost of $725 million. State officials in late 2006 reduced that estimate to between 140,000 and 160,000, a number that was surpassed last year.
"We're paying the price of our own success," said Mr. Widmer. From the beginning, many health policy specialists said the initiative would cost the state more than expected. Now, some say, the benefits of reaching near-universal insurance coverage may counterbalance the financial pain.
"I wouldn't say there's an imminent danger that the whole thing is going to collapse," said Robert Seifert, senior associate at the Center for Health Law and Economics at the University of Massachusetts Medical School. "It's challenging, but if it's a priority for the administration, then I think it's doable. There are benefits that don't appear in the budget numbers," including healthier residents, who are less of a financial drain in the long run. Government-funded costs of another part of the insurance initiativeexpansion of the state's Medicaid program, called MassHealthare also projected to grow significantly. The also state is seeking federal reimbursement for half of those expenses.
Boston Globe, 2/3/08
Colorado health care panel pitches plan
DENVER A state commission on health care has recommended that everyone in Colorado be required to have medical insurance and that the state put more money into child health care and Medicaid. The commission also recommended subsidies for low-income workers to purchase private insurance. The commission was appointed by lawmakers and Gov. Bill Ritter to find away to get health care to nearly 800,000 Coloradans who don't have insurance. Members have acknowledged their initiatives could cost millions of dollars, but they left it to lawmakers to figure how to pay for them.
"These recommendations represent a bold, yet realistic, approach to providing high-quality, affordable health care to all Coloradans, a roadmap to reform," commission chairman William Lindsay III said. "This is not merely a laundry list of suggestions. This is a comprehensive, integrated, interdependent package that can be implemented in stages." He said one key recommendation is requiring insurance companies to provide coverage to any applicant who doesn't have a pre-existing medical condition. People who have severe health problems but earn too much money to qualify for welfare or other low-income health programs would be eligible for CoverColorado, an existing state program for people who are denied coverage by insurance companies because of their medical conditions.
The panel said employers that don't offer health insurance should provide plans to help their workers buy coverage. The panel said administrative costs for physicians, hospitals and insurers could be reduced by streamlining processes and combining functions. Wellness programs could be encouraged by allowing health plans to discount premiums for people who have healthy behavior and eliminating copays for preventive care.
Associated Press, 1/31/08
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