Here’s just one example: the health reform bill will provide $4.1 billion in premium tax credits and cost-sharing tax credits for residents in Massachusetts from 2014 to 2019 to purchase private health insurance. Currently, Massachusetts spends about $88 million annually to provide subsidized coverage to enrollees in Commonwealth Choice. The new federal subsidies to 254,000 residents should lessen the amount of subsidies that need to be provided by the state.
The federal bill also strengthens the Commonwealth Connector’s power to pressure and negotiate with insurance companies for the best rates. Already, the Connector’s power to do that has kept the increase in premium cost in Massachusetts well below the national average. In fact, the average yearly premium cost in the individual market actually fell – from $8,537 at the end of 2006 to $5,143 in mid-2009. The federal bill allows the Connector to apply those principles even more broadly. I worked with my friend Harry Reid to make sure the Connector could negotiate with plans for lower bids, encourage plans to form select networks, and exclude plans that do not offer good value and cost-effectiveness.
This list goes on and on. I have a longer list on my website that you can read by clicking on this link to a PDF, but here are some major areas that are helped with a few examples on how they’re helped:
Medicaid/Medicare: The bill ends a system of Medicare payments that discriminated against Massachusetts hospitals, brings in $2 billion of federal aid for our Medicaid system over the next 10 years, closes the Medicare “doughnut hole” for prescription drug coverage, strengthens Medicare Advantage, provides free preventative care for Medicare recipients, and supports long-term home and community-based health care across the board.
Exchanges/Subsidies: In addition to what I mentioned earlier about the Connector and the new federal subsidies, the bill also preserves the Connector as the exclusive exchange in the state, lowers premiums for Massachusetts residents, and provides more generous eligibility for federal premium subsidies by raising the limit from 300% of poverty level to 400%.
This bill also helps Massachusetts by reforming many areas of the health care system. It invests in primary health care, alleviating a critical shortage of providers in that area. The funding for community health centers will be dramatically expanded, helping the 52 community health centers in the state that provide high quality health care to those in need regardless of their ability to pay. It maintains the strong consumer protection we have in Massachusetts, brings $100 million annually into the state to pay for Children’s Health Insurance Program … really, there are too many things to list all the ways this bill increases the quality of our healthcare system and starts to control the costs in the system.
Mitt Romney is contorting himself into a pretzel trying to pretend it’s not the case, but in many ways, the reformed system envisioned in our bill builds on and extends the model here in Massachusetts. And not if, but when it’s passed, it will strengthen what we do here in Massachusetts, and it will help tens of millions of people across the country get access to quality health care.
So – let’s get on with it.
I do not know the answer to this question so please accept this as an honest question. Will the House and Senate give up their insurance program and be covered under the terms of the insurance proposal being considered.
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p>Also why no tort reform?
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p>2. When the folks in the Congress who bang on the tort reform drum every chance they get (despite the small total overall savings) come to the negotiating table and work with the process, then we’ll get tort reform.
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p>You ought not get what you scream for just because you’re stomping your feet and being petulant. If the GOP would behave like a minority party interested in good legislation and work to shape the policy instead of just playing the NO game, we’d all end up with a better bill.
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p>No tort reform? Blame the Republicans for refusing to be part of the process.
There’s your process.
but I don’t really see how it relates…
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p> * English Rule: loosely speaking, the loser pays the winner for court costs. In American Rule, each side pays their own costs.
The incentive to step into court to take a swing at a marginal case, in hope of securing a business-reasons settlement, would be gone.
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p>The American Rule encourages lawyers/clients to take a shot because they have almost nothing to lose.
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p>Widespread use of the English Rule would go a long, long way to making sure that the only cases filed are the cases that are legitimate, and that people with those cases don’t lose their rights.
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p>This would be a good first step to see if the medmal problem can be reduced.
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p>In my view, there cannot be meaningful cost control in the system, so long as physicians are motivated, as they are presently, never to decline ordering a test, for fear of being sued for missing something. The present incentives are thoroughly skewed to overconsumption and overspending.
Most personal injury cases are financed by contingency fees – no judgement for the plaintiff, no money for the attorney.
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p>This ironically makes the greed and ambition of the tort bar a force for accountability, particularly for those who are screwed by corporate corruption, with no recourse short of the civil courts.
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p>Whatever my opinion of many tort lawyers as individuals, they serve (on balance) a positive role in the total scheme of things.
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p>Regarding your last paragraph: IMHO the prime generators of high health care costs are a cultural bias within the medical professions in favor of technological fixes; an overdependence on the pharmaceutical industry for drug information; top-to-bottom corporatism from insurance companies, through hospitals, to medical practices; and a pro-specialist, anti-preventive bias on the part of doctors and medical students, consistently reinforced by peer pressure from pre-med through medical practices.
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p>I would stipulate that malpractice premiums are far too high for the average competent MD, but transparency in terms of the records of bad apples within the health professions would, IMHO, go far to remedy that.
There are plenty, and I mean plenty of lawyers who will take something marginal on a contingent fee. They take their shot, and the defense calculus is: it will cost $X to defend, and they know it, and so they will go away for 3/4X, so settle because it costs less.
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p>Your theory only works when the plaintiff’s atty invests resources of time and money to hire expert witnesses.
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p>Now that the bill has passed, people who use the words “corporatism” and “technological fixes” in describing how to reduce costs are frightening indeed. My body is a mechanical thing powered by chemistry. Fixing it when something isn’t working–far more so than keeping it there in the first place–is all, all bout technology. I would prefer that the technology be there when I need it, AND that the doctor doesn’t feel compelled to use it unnecessarily for fear of being ruined by a tort judgment.
I’ll trade ya tort reform for a public option, with an end to insurance companies’ antitrust exemption. Those three changes combined would likely lower costs to consumers.
I just got the letter, my health care premium will go up 25.5% starting May 15th. I will pay $866/month for this. Today we pay $690.
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p>My home mortgage is about $1375, including an escrow for taxes.
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p>I am not ranting at Fallon. It is what it is and it IS what I choose. It’s the system! It is upside down, against the working class.
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p>The policy above for a Single is $286, 1+Child(ren)=$514, two adults=$614. I have the Family coverage, $866.
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p>This must stop.
I went to the ‘exchange” we have here in Mass. Putting in my family specifics:
Family of 4 in Lowell, MA
Adult1: 46, Adult2: 44, 2 Children.
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p>Picking the mid-range for each cost group, this is what I get for options.
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If he is against helping the people in Massachusetts he should tell us why. Specifics would be nice.
“the average yearly premium cost in the individual market actually fell – from $8,537 at the end of 2006 to $5,143 in mid-2009”
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p>Sorry, but this is pure and utter crap. If the individual market fell, then why did my insurance go UP 27% ($110 MORE per month)? I don’t think insurance premiums went down – I think people got less expensive plans. I couldn’t go any lower because if I had and I had gotten sick then between the co-pays, deductibles and the percentage I would have had to come up with – I would have gone bankrupt.
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p>It’s time to stop reading the rhetoric and start looking at the actual facts.
but my BC/BS premiums were going to go up by 25% this year alone. The employer kept the premiums down by shifting more of the cost onto employees through doubling deductibles and co-pays. While that would show up in the Senator’s statistic as no increase in premiums, it is definitely an increase in cost for me.
And, as with most varieties of positive change, this IS about progress not perfection.
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p>I agree – “Let’s get on with it”, and move on to the festering issue of job creation, retention and recreation of manufacturing capacity, and the economy.
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p>.
The voiceover doesn’t cite which bill — or which draft of that bill — he’s claiming these quotes come from.
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p>Without that, it just isn’t legit.
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p>Thanks for playing.