I was surprised to read the July 13 editorial in the Sun Journal, “Cracks appear in logic behind health care plan,” stating that the new national health care law will not meet expectations because it is based on the Massachusetts model. However, the editorial did not take into account the fact that the federal law is far more comprehensive and has addressed some of the shortcomings in the Massachusetts law.
The Sun Journal editorial stated that the Massachusetts model allows “gaming” the state’s individual coverage plan. Individuals sign up for insurance only when they need an expensive procedure, such as surgery, and then drop the coverage after they recover.
The fact is that a new Massachusetts study finds that only 1 percent of premiums are impacted by this “gaming.” This is a modest impact and the new federal law, The Patient Protection and Affordable Health Care Act, includes restrictions on open enrollment periods which will limit the “gaming” of the system.
The PPACA includes cost-control measures such as an independent rate-setting board for Medicare, pilots of innovative medical reimbursement approaches, and an end to the open-ended tax subsidy to the highest-cost health insurance plans in the U.S.
The Massachusetts model sought to control certain costs through universal coverage — similar to the version passed into law at the federal level. However, that is about as far as the Massachusetts law went. The federal health care law has many more provisions aimed at slowing the rate of increases in health care that no state could adequately undertake on its own. The editorial also ignored the fact that the Massachusetts model has, in fact, largely controlled the costs it was intended to address.
The Massachusetts plan has resulted in slowing the rate in increases in premiums for individual market plans — as was its aim. Those rate increases have been held to half the national average. The Massachusetts law now covers 90 percent of its citizens and has extended coverage to 60 percent of the state’s uninsured.
In meeting that extraordinary challenge, the effort has stayed close to the costs expected before the law was passed in 2006.
Perhaps most notably, the law is overwhelmingly popular with the people of Massachusetts.
We should be grateful to Massachusetts for leading the way to accomplish this important task.
State Rep. Pat Jones, Mt. Vernon
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