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WHAT'S NEXT FOR THE CONNECTOR by Leslie Kirwan

Last week, the Board of the Commonwealth Health Insurance Connector Authority met for the first time since early July. The meeting was a kick-off to a busy Fall and then 2008 for the Connector, as it continues to complete initial policy and operational tasks related to health reform and commences “round two” of addressing some recurring issues.

For those who weren’t able to attend the Connector’s Board meeting, here are some of the challenges that were flagged on a draft calendar discussed at the meeting (note: these are surely not the only issues the Connector will focus on – just some of the most obvious and pressing ones).

Commonwealth Care: the related tasks of evaluating experience under the program so far, considering program design moving forward, and negotiating new contracts with the managed care organizations which provide health insurance under this program.

Commonwealth Choice: renewing the Seal of Approval for health plan contracts (six private health plans currently provide health insurance under this program); also, working towards allowing small businesses that contribute to health insurance to offer Commonwealth Choice plans.

2008 Penalties: in consultation with the Department of Revenue, reviewing the schedule of penalties in 2008 for those who can afford health insurance but fail to purchase it (as we near year two of the individual mandate, we hope to have a 2008 penalty schedule that is fair, workable and provides a meaningful incentive for those who can afford insurance to get it).

Minimum Rx Benefit/MCC: The Connector’s minimum creditable coverage regulations (defining the minimum level of health insurance that will satisfy the individual mandate) require adults to have prescription drug coverage as of January 1, 2009. This project follows up on those regulations by elaborating on what constitutes a minimally acceptable drug benefit – specifically, examining the possibilities for constructing a minimum benefit that provides first-dollar coverage for certain drugs but also limits the overall impact on premiums (through greater cost-sharing in other areas).

Affordability Schedule: The Connector will need to update its affordability schedule (which helps determine who can afford health insurance) for 2008, the second year of our individual mandate.

The entire draft calendar (with some proposed dates for addressing these issues) will soon be posted on the Connector’s website. The calendar is a draft, and Board members provided some very useful suggestions on other priority items for the Connector – so this is certainly subject to change and refinement over time.

I was also heartened to hear “across the Board” (literally) interest in focusing on health care cost containment. The message that cost containment is essential to the success and sustainability of health reform has echoed on this blog since its creation. The Connector has a number of levers at its disposal to promote improvements in the efficiency and quality of health care, as do other parts of state government involved in the purchase and delivery of health care (for example, MassHealth and the GIC). There is great potential for collaboration between these entities (and also with non-governmental health care players) to help “bend the cost curve” in a favorable direction. Definitely more to come on this front.

Leslie Kirwan
Secretary of Administration and Finance for Governor Deval Patrick

This program aired on September 27, 2007. The audio for this program is not available.

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