Fair Share of Coverage?

Massachusetts' landmark effort to cover uninsured residents is built on the premise that individuals, companies, and the government share responsibility for the success or failure of the law.

The first numbers on whether employers are doing their fair share were released yesterday, and the question of fairness is still not settled. WBUR's Martha Bebinger has this update.


BEBINGER: The law says employers have to report how many workers they have and how much, if anything, they contribute to health insurance. Those with 11 or more employees, that don't meet state coverage standards, must pay a $295 fine for each worker. Jim Klocke, executive vice president with the Greater Boston Chamber of Commerce says the first round of employer reporting is very encouraging.

KLOCKE: These show that we have very strong employer participation in health insurance in Massachusetts. 97% of the companies who have filed are in compliance with the new law.

BEBINGER: The numbers are preliminary...about a third of the firms in the state have not yet filed. Those 21,000 companies will receive reminder notices next week. If they don't file by early next year, they will be fined. Some health care consumer advocates are suspicious that there only 518 firms so far that don't provide health insurance. The fines for those firms total 5 million dollars. When the bill passed, the legislature estimated the $295 penalty would raise 48 million dollars. Health Care for All Director John McDonough.

The fact that employers aren't generating the level of revenue anticipated, means that there is a higher burden falling on the state's taxpayers and the state's general fund.

BEBINGER: Business groups says estimates about how much this fine would raise were based on speculation. But some legislators who wrote the law say businesses are getting off too easy. It's all in how the state defines the requirement that "employers must make a fair and reasonable contribution toward health coverage for employees." Right now, if employers have 25% of workers in a company health plan or pay a third of the cost of insurance for even one employee, they don't pay a fine. Representative Patricia Walrath, the house point person on the health care law...says the threshold should be...paying at least 50% of the insurance plan for at least half of the company's workforce.

WALRATH: It does seem that the employers part of the three legged stool that we're supposed to be talking about sharing is not at the same level as either the government or the individuals.

But other state house leaders and representatives of Patrick administration say they are pleased with the level of employer coverage. Business groups say the $295 fine was never meant to be a significant funding stream for the law. It was meant to level the playing field among employers. Companies that insure workers already pay about $295 for each worker, on top of health plan costs, to fund free care for the uninsured. Massachusetts Taxpayers Foundation president Michael Widmer says those companies expect to spend an extra 100-million dollars this year to help cover uninsured workers.

WIDMER: The major way in which additional employer dollars are going to fund health care reform is through employees who have declined an employer's offer because of the Individual Mandate.

BEBINGER: But the debate about whether employers need to do more will continue as the cost of covering the uninsured in Massachusetts rises. For WBUR,

This program aired on November 22, 2007. The audio for this program is not available.


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