Mass. Health Care Review: Premiums to Rise 10% in 2010 with Pre-Existing Conditions subject to waiting period – U.S. Congress Adopts Mass. Model

Nancy Pelosi - Taking a Page from the Massachusetts Health Care Model? image cinisworld

Massachusettsresidents who hold private insurance plans are bracing for a 10% increase in the cost of their premiums in 2010. Blue Cross/Blue Shield, the Commonwealth’s largest insurer, has set premium increases for individuals at 10 to 11% while those who are self-employed, can anticipate a higher increase. This can mean up to a $40 per month drain on families who are already burdened with risings costs to do the rise in Massachusetts taxes imposed this year in order to cover the Commonwealth’s deficit. Subsidies for the Massachusetts Health Insurance model, remain one of the Commonwealth’s largest expenditures, and with an ever decreasing tax base, one can anticipate yet another round in taxes in 2010 to help foot the bill.

What about pre-existing conditions? Under Massachusetts laws, Pre-exiting conditions are not excluded, rather subject to a “waiting period” of up to six months.

Fees versus taxes, waiting periods versus exclusions; it’s all about parsing a phrase.

Those who live in the Commonwealth and are not covered under the mandatory health insurance laws, face paying a “fee” every year to the Massachusetts Division of Insurance. Although Massachusetts boasts the highest rate of insured’s in the nation, individuals and families who cannot afford the premiums, yet earn too much to qualify for subsidies are met with an additional tax burden.
Meanwhile, the few insurance carriers that are allowed to do business in the State, point to the 26 State mandated benefits they must cover as part of the reason for the increase.

The Health Care Reform Bill that Speaker Nancy Pelosi is blindly pushing through Congress, includes an interestingly similar feature to the Massachusetts model: under the proposed plan, those who are subject to pre-existing condition clause, will be subject to a “waiting period” of up to six months, before “Congress-Care” kicks in. Meanwhile, private insurance companies will be forced to pay into an ever increasing “risk pool” – driving up premiums for those who still have private insurance plans.

Although the Congressional version of Health Care Reform, has some level of approval from only 42% of the nations populace Ms. Pelosi’s’ intends to push the bill to a vote, despite an obvious message sent to those who would consider adding additional economic burdens to the nation this past Tuesday. Statewide wins for Conservatives in both Virginia and New Jersey, have been dismissed by the Speaker.

What is most startling is that the Speaker, and those Representatives in Congress who reside in the Commonwealth of Massachusetts, surely must have access to the data, yet they are willing to foist this flawed program on the rest of the nation. A common sense solution would be to allow for competition in the state (proposed by the House Republican’s), allowing only those benefits that relate to preventative care to be mandated, allowing insurers to offer plans that provide those “high price tag” benefits currently offered under the Massachusetts model (infertility treatments for example), at a higher rate, reducing the risks assessed across the board to consumers. To use the Massachusetts Model for the Nation is, in a word, economic suicide, which does little to aid those who are caught with a debilitating illness in a six month “waiting period”, and raises both premiums and taxes on those who are still employed.