The Connector Board is about to make two decisions that are critical to the success of health care reform - the elements of minimum creditable coverage (MCC) and the standards of affordability for enforcing the individual mandate.
There is a tendency on the part of advocates and others to overreach in both areas - setting the MCC requirements too high and establishing affordability standards that are too broad. Doing either, or both, risks dealing a fatal blow to reform.
One of the key elements of health reform was to bring as many of the uninsured as possible into employer-based coverage. Health reform was never about setting a universal standard for all employers which would disrupt the existing insurance market and force a large group of employers to amend coverage that already provides a good benefit package valued by employees. At a minimum, if the Connector decides to mandate drug coverage, there should be a two-year period to allow employers ample opportunity to make this change.
Similarly, the Connector should resist the temptation to adopt a too sweeping standard of affordability which would have the effect of undercutting the individual mandate and discouraging younger, healthier individuals from buying insurance. It is better to back off on the penalties in the early stages of reform than to exempt too large a group from the requirement to purchase insurance. There is little, if any, likelihood that the state will have the money to broaden subsidies in the years ahead.
Michael J. Widmer
Massachusetts Taxpayers Foundation
This program aired on March 19, 2007. The audio for this program is not available.