A Quick Note on Two Elements of Health Care Reform by Leslie Kirwan

1. We are making the transition from establishing the rules of health care reform to putting those rules into action. So it’s critically important that we help individuals, employers and others understand new opportunities to purchase quality, affordable health insurance, as well as their respective obligations under health reform. This was underscored for me the other night, when I participated in a forum on health care issues hosted by the Commonwealth Institute. The Institute supports the efforts of women entrepreneurs and senior corporate executives to grow their businesses and careers. Along these lines, it asked Charlie Baker of Harvard Pilgrim Health Care, Jim Roosevelt of Tufts Health Plan and me to participate in a panel discussion centered on the impact of health reform on businesses. We received many great questions from the audience, a good number of which focused on the day-to-day implications of health reform for businesses.
I thought it would be instructive to list some of these questions, to highlight issues on the business community’s radar screen.

Here’s a sampling (in paraphrased form):
• Can I just offer insurance to my employees, or do I have to offer it to their family members as well?
• Can I contribute differently to part-time and full-time employees, or to different part-time employees?
• Can I contribute differently to different groups of full-time employees?
• What are the HIRD forms?
• How do I avoid being penalized by new assessments in health reform?
• Why should I bother setting up a Section 125 plan?
I know that there are a number of efforts under way to help businesses large and small understand the new world of health reform. For example, the Connector participated in forums across the state hosted by Associated Industries of Massachusetts and local chambers of commerce to explain how health reform will affect businesses. These and other outreach initiatives have made real progress in introducing health reform to businesses and entrepreneurs, and we all appreciate the hard work that has gone into them. We need to keep this up to reach additional businesses and answer the host of good questions out there.
2. In my last blog, I briefly mentioned the State Children’s Health Insurance Program (which provides health insurance to about 88,000 children in Massachusetts up to 300 percent of the federal poverty level ) and said to keep an eye on supplemental appropriations legislation then pending in Congress for potential progress relating to the program. I wanted to briefly follow up on this issue.
We initially faced a federal funding shortfall for S-CHIP of almost $142 million for federal fiscal year 2007. Part of this shortfall ($62 million) was eliminated by federal legislation signed into law in early January of this year. The more recent development (though hardly breaking news at this point) is that in May, Congress passed and the President signed supplemental appropriations legislation that provides an additional $80 million in federal matching S-CHIP dollars for Massachusetts, eliminating the shortfall we had faced. This infusion of federal funds helps not only sustain our state’s S-CHIP program without interruption or restrictions of service but also improve our “budget neutrality” picture (basically, allowing us to use federal resources provided under our Medicaid waiver for other critically important health care purposes). Securing this funding was a priority for Governor Patrick, and we greatly appreciate the efforts of our congressional delegation to deliver this much-needed relief.
The work in this area is not yet done, however. The current federal authorization for the S-CHIP program expires on September 30, 2007 (the end of federal fiscal year 2007). We need S-CHIP to be reauthorized to help us continue providing health insurance to our children who are currently covered through the program, as well as to eligible children who are not yet enrolled. There are indications that legislation to reauthorize S-CHIP will be considered by the full U.S. Senate following its July 4th recess. All eyes on Congress over the coming weeks on this critical issue for our children’s health and our state’s fiscal health.

Leslie Kirwan
Secretary of Administration and Finance for Governor Deval Patrick
Commonwealth Connector Board chair