"What's Next for Health Care Reform" by Leslie Kirwan

Budget season is in full swing, making the Executive Office for Administration and Finance an extremely busy place (not that it ever isn’t). In the midst of analyzing the just-released Senate Ways and Means budget, a few quick thoughts on health care:

• The main message coming out of Monday’s Blue Cross Blue Shield Foundation event examining one year of health care reform is – cost is the next frontier of reform.

Restraining costs is critical to making health care more affordable for those who currently lack health insurance; for individuals and families who are struggling to pay for the coverage they already have; for businesses who offer coverage and those we hope will do so in the future; and for government at every level, whose budgets are being stretched thin by rapidly increasing health care costs.
I am very encouraged that people are turning their attention to this issue. The Governor’s budget, the House budget, and the Senate Ways and Means budget all include initiatives to restrain Medicaid costs while also improving service delivery. The Health Care Quality and Cost Council is up and running, and we’ll soon be implementing a system requiring hospitals to meet performance benchmarks in order to receive increased reimbursements from the state. Governor Patrick’s Municipal Partnership Act would allow cities and towns to provide health insurance to municipal employees through the Group Insurance Commission, leveraging the state’s purchasing power and expertise to offer quality health care at a more affordable price. A renewed investment in public health was an important focus of health care reform and is a major theme of this year’s budget proposals, emphasizing the value of prevention in improving health and reducing long-term health care costs. There are also many ideas for using technology to reduce unnecessary paperwork and administrative costs in our health care system, and for promoting greater transparency to help consumers to make cost-effective health care choices that best suit their needs.
Health care reform became law because people from across the spectrum were deeply committed to expanding access to health insurance, open to compromise, and willing to take risks. I hope we can bring the same spirit to the closely related task of restraining health care costs. Wouldn’t it be great if we led the nation once again in tackling one of the foremost challenges in health care?
• Maintaining a strong partnership with the federal government is essential to our ongoing efforts to expand coverage to the uninsured. Our existing federal Medicaid waiver is joined at the hip with health care reform, helping us pay the cost of subsidizing health insurance for those who would have difficulty buying it on their own, and broadly setting an expectation that we will make progress in moving people (and dollars) from sporadic care in emergency rooms to preventive and comprehensive care through health insurance. Over the next fourteen months, the Executive Office of Health and Human Services will be negotiating with the federal government to renew Massachusetts’ Medicaid waiver, so we can continue working in tandem with the federal government to make the Massachusetts model the success it can and should be.

The Administration is also actively supporting efforts in Congress to provide additional funding through the State Children’s Health Insurance Program (S-CHIP) for current needs, and to reauthorize the program moving forward. This is extremely important to Massachusetts. S-CHIP was pioneered in the Commonwealth and covers 82,000 children across the state. Keep an eye on supplemental appropriations legislation being considered in Congress for some potential progress on this issue.

• May 1 was another milestone for health care reform, as the Connector launched the Commonwealth Choice program offering a range of new, more affordable health insurance products for individuals and (ultimately) small businesses. The Connector’s new website allows people to compare health insurance products in a true “apples to apples” way across the major health plans. This is helping to make the costs and benefits of health insurance products more transparent.

According to the Connector, there has already been lots of interest in Commonwealth Choice. They’ve received over 24,000 visits to the website (which generated close to 270,000 page views) and over 7,000 calls to the Commonwealth Choice call center. We can expect even more when a major marketing campaign launches later this month. The Connector is also starting to receive applications and paid enrollments (people have until 6/28 to enroll for 7/1). And the Connector is improving program administration and efficiency in several ways, including using a common enrollment form for Commonwealth Choice (before this, people would have had to fill out a different application for each health plan).

Having worked through the bidding and Seal of Approval process for these products as a Connector board member, it is exciting to see Commonwealth Choice in action. Congratulations to the hard-working staff at the Connector for getting things under way and working so hard to make this program a success.

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

This program aired on May 17, 2007. The audio for this program is not available.

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Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.



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