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Massachusetts Health Reform: A Giant Step Toward Universal Coverage?

This report explores the Massachusetts Health Reform, a mixed private-public system that aims to achieve universal coverage through various measures such as Medicaid expansion, individual mandates, employer contributions, and a group insurance exchange.

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Massachusetts Health Reform: A Giant Step Toward Universal Coverage?

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  1. Massachusetts Health Reform:A Giant Step Toward Universal Coverage? Anne Gauthier Assistant Vice President Deputy Director, Commission on a High Performance Health System The Commonwealth Fund Alliance Briefing for Congressional Staff November 7, 2008

  2. 1999–2000 2006–2007 NH ME WA NH VT ME WA VT ND MT ND MT MN MN OR NY MA WI OR MA NY ID SD WI RI MI ID SD RI WY MI CT PA WY NJ CT IA PA NJ NE IA OH DE IN NE OH NV DE IN IL MD NV WV UT VA IL MD CO DC WV UT VA KS MO KY CA CO DC KS MO KY CA NC NC TN TN OK SC AR OK AZ NM SC AR AZ NM MS GA AL MS GA AL TX LA TX LA FL FL AK AK 20% or more HI HI 16%–19.9% 12%–15.9% Less than 12% Percent of Nonelderly Ages 0–64 Uninsured by State Data: Two-year averages 1999–2000 (updated with 2007 Current Population Survey correction) and 2006–2007 from the Census Bureau’s March 2000–2001 and 2007–2008 CPS.

  3. Elements of the Massachusetts Health Plan • Mixed private-public system of universal coverage • MassHealth expansion for children up to 300% poverty; adults up to 100% poverty • Individuals must buy coverage or face a penalty as of July 1, 2007, with affordability provision; full premium subsidies between 100% and 150% of poverty and partial subsidies between 150% and 300% of poverty; individual assessment of 50% of minimum premium (raised January 2008) • Employers must offer coverage or pay fair share contribution ($295 per year) and allow employees access to pay premiums with pre-tax dollars • Connector to organize affordable insurance offerings through a group insurance exchange (open enrollment began July 2007) • Massachusetts Health Care Quality and Cost Council established to address cost containment and delivery system reform Uninsurance Rate Among Working Age Adults, 2006

  4. The Role of Employer Coverage: Massachusetts and the United States, 2006-07 Massachusetts Adults 19-64 United States Adults 19-64 Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2007 and 2008 Current Population Survey (CPS: Annual Social and Economic Supplements).

  5. Comparing Plans: President-elect vs. Massachusetts * Estimates of uninsured covered from L. Burman, S. Khitatrakun, G. Leiserson et al., An Updated Analysis of the 2008 Presidential Candidates’ Tax Plans, Urban Institute–Brookings Institution Tax Policy Center, Updated September 12, 2008.

  6. Comparing Plans: President-elect vs. Massachusetts 0 = Minimal or no change from current system; — = Worse than current national system;+ = Better than current system; ++ = Much better than current system Source: S. R. Collins, C. Schoen, K. Davis et al., A Roadmap to Health Insurance for All: Principles for Reform (New York: The Commonwealth Fund Commission on a High Performance Health System, Oct. 2007).

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