If national health reform was going to somehow slow our progress in Massachusetts, we would oppose it. But the bill we passed through the Senate will do tremendous good in Massachusetts, as it will in every other state. The Senate bill:
+ preserves the ability of the Health Connector to be the exclusive exchange in Massachusetts.
+ provides $447 billion in federal subsidies nationwide, which will help to free up state resources for Commonwealth Care subsidies.
+ provides federal subsidies to individuals and families with incomes up to $43,320 for individuals and $88,200 for families of four. This will reach help thousands of Massachusetts families, as our state currently provides subsidies to individuals and families with incomes up to $32,490 for individuals and $66,150 for families of four.
+ provides tax credits to Massachusetts’ small businesses, including nonprofits, that have less than 25 employees and which offer health insurance.
+ recognizes the efforts of Massachusetts in expanding health care coverage to low-income individuals by providing our state with a $500 million increase in federal Medicaid funds from 2014 to 2016.
Contrary to some claims, the Senate bill also benefits Medicare recipients in Massachusetts. One million of our seniors will receive an annual wellness visit. Approximately 180,000 of our seniors who have fallen into the Part D prescription drug doughnut hole will receive a 50 percent discount on brand name drugs — and we believe we can close the doughnut hole altogether when the Senate bill is merged with the House bill. The bill also improves the complex reimbursement formula in a way that will save Massachusetts hospitals at least $300 million a year. It helps older Americans maintain their retiree health coverage and gives them access to a new voluntary long-term care insurance program which allows them to remain in their homes and communities and avoid being institutionalized. This is one of the many reasons the legislation is supported by AARP.
The Senate bill further makes significant investments in primary care, modernizes payment systems, and rewards high quality care. It simplifies and standardizes paperwork, reducing the 4.8 million hours and $2.3 billion in paperwork costs for the more than 34,000 physicians in Massachusetts, and gives doctors in our state more time to focus on caring for patients instead of dealing with bureaucracy.
There have also been exaggerations leveled against the provision in the Senate bill that places an excise tax on the insurance companies that offer high cost health insurance plans. This measure will affect only a small portion of the very highest cost health plans and will ultimately contain health care costs across the board. We are working with congressional leadership and the White House to ensure this measure is adjusted to not hurt labor members in Massachusetts, who are the very bedrock of our vital middle class.
The legislative process has been a long process. But America is finally about to join all the other major industrial nations in the world that already guarantee health care for all of their people. That we are closer than ever to doing so shows not only the extraordinary challenge this undertaking has been but also the hard work, skill and dedication of our leaders, including one in particular – Ted Kennedy.
In the past, every time Congress came close to making health reform a reality, the details and the old divisions got in the way. Senator Kennedy said his greatest regret in a triumphant Senate career was holding out for too much when significant bipartisan reform was possible with the Nixon Administration in the 1970’s. We will not pass a perfect bill in 2010. But we can take huge strides toward significant reform.
Affordable health care for all Americans was Ted Kennedy’s number one legislative priority. He held out hope it would be this Congress that finally makes that cause a reality. We share that hope – that together we can achieve health care that is true to the principles and character of our country, and that builds on the leadership of Ted Kennedy that was so helpful in bringing reform to Massachusetts.
We’ve been running away from the issues – letting the right define the health care debate, even here in Massachusetts, where our landmark law serves as the model for national legislation. Its about time we start talking about the positives in this bill – and not the difficult compromises made to pass it.
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p>Win or lose – if there is one lesson we must draw from the Coakley race it is that we have to be out there making the case for our policies clearly and assertively – from day one, over and over again. I know we’ve been trying but we have to try harder to get the message out over the din of right-wing lies and attacks.
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p>Because the GOP abandoned the field, the health care debate has strictly been an in-party discussion. We’ve been talking among ourselves and that has got to end. Hopefully, this is the wake up call we needed.
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p>And whatever happens tomorrow, we need to pass the bill. 59 or 60 doesn’t matter. After all the mess, coming out of this empty handed is not an option. If 2010 is going to be a tough year for us at least we will have gotten this done – something that will stand the test of time.
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p>So Senators, I implore you to do whatever it takes to pass this. Convince the House to pass the Senate bill down to the letter if needs be and make further reforms through the budget reconciliation process where only 51 votes are needed.
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p>And, I think it may also be time for you to consider how to fix the Senate. The filibuster can work both ways – and Democrats have used it in the past. But it has gotten out of control and is perverting the will of the people. Ensuring debate is one thing. Preventing votes on every matter before the Senate is quite another.
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p>So call the GOP out on it. They are the party of NO. The party of the intolerable status quo. That is the fight we need to carry into the mid-terms, Scott Brown or no Scott Brown.
All well and good, but please talk to small businesses in Massachusetts before you blithely brush away the concern with this provision (and buying off CBA and government workers doesn’t exactly fill one with confidence). Our small business was looking at an increase in family premiums with BCBS this year from $18k to $22k here in MA. We don’t think of our current plan as “Cadillac” in any extent (it isn’t). And we can certainly see the handwriting on the wall that 2013 costs will put pretty much every plan in MA into that position for small businesses.
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p>Understanding the reasoning of the Senate’s approach on the Cadillac tax basically devolves down to pushing employers to move to lower cost, higher deductible plans (but now out of pocket expenses for employees are significantly increased – and we’re not talking about moving $10 up on an office visit). This may make economic sense in driving down health care expenditures, but both the House and Senate bill propose implementing a cap of $2,500 on Flexible Spending Accounts (and the fine print doesn’t even say whether or not this would be indexed for inflation).
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p>My coworker in her late 50s with health issues is currently setting aside $6,000 a year into our company’s flex account (and which she expends each year). Not rich by any means, but assuming a 25% Fed marginal rate on her income, such a cut in the cap means that she’s looking at annual additional costs to her of around $1400 per year in taxation. This worker is not rich by any means.
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p>Our state is certainly the first to lead the way in health care reform; it also is first in the highest insurance premiums in the nation.
This wonk talk doesn’t get me excited about the health care bills.
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p>Here’s something I did see this AM on Facebook, from a distant friend, that did get my attention:
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p>Health care reform proponents have, in my opinion, rarely done a good job (especially recently) of making something big and complex accessible and meaningful.
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p>We need:
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p>Simple
Unexpected
Concrete
Credentialed
Emotional
Stories