IN AN EFFORT TO CONTAIN ITS growing budget deficit, Massachusetts' 2010 budget eliminates healthcare coverage for some 30,000
legal immigrants, according to The New York Times. The cut, which would save an estimated $130 million, affects permanent residents who have had green cards for less than
five years, are between ages 18 and 65 and are not disabled. This group is currently covered under Commonwealth Care, a subsidized
insurance program for low-income residents.
Immigrant, labor and healthcare advocates are pushing to have enough funds added as an attachment to the budget to ensure
no loss of coverage next year, and Gov. Deval Patrick has proposed restoring $70 million to the program, which would partly
restore the immigrants' coverage. But legislative leaders have balked, saying vital programs for other groups would have to
be cut as a result.
Commonwealth Care plans to save an additional $63 million by no longer automatically enrolling low-income residents who fail
to enroll themselves.
Even as the state works to trim healthcare costs, however, Massachusetts legislators are introducing legislation to expand
medical services insurers are required to cover, according to the Boston Globe. This year more than 70 bills have been introduced that would mandate coverage of myriad conditions and treatments, such
as hearing aids for children. PAYMENT SYSTEM UNDER FIRE
A state commission has recommended that Massachusetts dramatically change how doctors and hospitals are paid, essentially
putting providers on a budget as a way to control healthcare costs and improve the quality of care. The 10-member commission,
which includes key legislators and members of the governor's administration, voted unanimously to scrap the current system,
in which insurers typically pay doctors and hospitals a negotiated fee for individual procedures and visits. Instead, PCPs,
specialists and hospitals would group into networks and be responsible for an individual's well-being and be compensated with
a flat monthly or annual fee known as a "global payment."
The commission, which recommends the change be carried out over five years, stressed the importance of changing the way doctors
and hospitals are paid not only by private insurers but also by Medicare and Medicaid, a change that would require federal
approval. The legislature and governor must vote on the proposed change before it could take effect.In 2006, Massachusetts
adopted a healthcare law that has attained near-universal coverage.?"But the plan has done little to control costs, which
now are 33% higher than the U.S average and projected to grow faster than the rest of the country," the commission says.
Since implementation of healthcare reform, enrollment in private insurance has risen by 190,000, accounting for 45% of total
growth in coverage.
MHE Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The
Commonwealth Fund; National Center for Health Statistics; Robert Wood Johnson Foundation; Health Care in Massachusetts: Key
Indicators (May 2009) report
