To close its budget shortfall, in 2009, the Connector hopes to raise $33 million from penalties on nonparticipating employers, tax health insurance company reserves to raise another $33 million, and tax physicians and hospitals for an additional $28 million. The math is complicated by Massachusetts’ paying physicians and hospitals 80 cents on its federal Medicaid and Medicare dollar, leaving large health plans such as Blue Cross/Blue Shield, Harvard Pilgrim, Tufts, and Fallon to shift costs to insurers. The insurers, in turn, raise premiums to employers and consumers, leading to unaffordable premiums for the uninsured.
Explore This IssueSeptember 2008
Connectors also present legal issues including ERISA pre-emption, conflicts with HIPAA and COBRA, forcing SEC 125 plans to conform to Connector provisions, and adverse selection from guaranteed issue. Additionally, mandatory participation in insurance coverage via increasing penalties does not address consumers’ unwillingness to purchase expensive plans that include state mandates over less expensive plans with fewer benefits, high deductibles, and health savings accounts. Devon Herrick, PhD, Senior Fellow-Health Care at the National Center for Policy Analysis, warned that insurance plans with costly mandates offered through Massachusetts’ Connector make premiums unaffordable and shift the cost burden to taxpayer. Governor Romney tried to get a mandate-free plan and failed. A national plan will be the same because all the special interests jump in to protect their mandated coverage, he said.
To Reach ENT Today
For Editorial, Permissions, or Publishing Matters:
ENT Today Lippincott Williams & Wilkins 333 7th Avenue, 19th Floor New York, NY 10001 Phone: (646) 674-6544 Fax: (646) 674-6500 ENToday@lwwny.com
For Advertising Sales:
Michael Guire Lippincott Williams & Wilkins 1300 Virginia Drive, Suite 400 Ft. Washington, PA 19034 Phone: (215) 643-8140 Fax: (215) 643-3902 Michael.Guire@wolterskluwer.com
©2008 The Triological Society