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Mass. Health Connector In NYT: Promise And Perils Of Insurance Exchanges

This article is more than 7 years old.
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Abby Goodnough, the outgoing Boston bureau chief of The New York Times, is now shifting to the health care beat, and if this surprisingly readable profile of The Massachusetts Health Connector is any indication, that is a very good thing.

The Connector, of course, is the agency that helps Massachusetts residents shop for and obtain health insurance — the sort of insurance marketplace or "exchange" that is slated to crop up in states nationwide, as many more people get health insurance under Obamacare. If Obamacare continues to exist after the Supreme Court's expected ruling this month, that is.

So, as in so many things related to health reform, the nation's eyes (or their media surrogates) turn to Massachusetts to see how this stuff works. The state of play:

The law requires every state to establish an exchange, but many are balking, complaining about everything from the expense to the perceived federal intrusion. Some, like Louisiana and Maine, are refusing. Others are deferring crucial decisions until the court rules and the November election plays out. So far, only about 15 states and the District of Columbia have established exchanges, with California and Maryland among the furthest in their planning.

The experience of Mr. Kim in Massachusetts, which with Utah is one of only two states with an exchange up and running, illustrates how exchanges are ideally supposed to work. After just an hour of research on the exchange’s Web site, he says, he found a better deal. He enrolled in a plan through Harvard Pilgrim for which he pays $1,086 a month for his family.

Sounds good so far. Now for the challenges:

But for all Mr. Kim’s satisfaction, Connector officials acknowledge that they need more consumers like him — full-paying customers who do not qualify for a government subsidy to offset their premiums. So far the program has drawn only about half of that population in the state’s individual market, according to Connector officials.

Instead, about 82 percent of the roughly 224,000 people insured through the Connector have incomes low enough to qualify for state and federal subsidies. They pay a modest premium or none at all. This is precisely what many opponents of exchanges fear, that instead of a free marketplace they will become something resembling an extensive public welfare program.

The Connector has struggled mightily to attract another important constituent of the national health care overhaul efforts — small businesses, which have long complained of being priced out of the health insurance market.

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Readers, your own reviews of the Connector?

This program aired on June 13, 2012. The audio for this program is not available.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.

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