Rationale
At the beginning of the 21st century, the population of Massachusetts faced healthcare issues caused by the rising costs. The previously developed Medicaid program was expiring, and the necessity to create a new solution occurred because the representatives of the general public could have become unable to pay for the required care. Being at risk of having their Medicaid coverage expired, people started worrying because of the possibility to face critical financial problems. There was an attempt to provide citizens with individually purchased insurances, but it was not successful even though they seemed to be rather popular initially.
Insurance costs rose extremely fast, and people became unable to buy them. The most critical situation was observed among the representatives of the low-income population. Moreover, the majority of employers refused to include health coverage in the range of employee benefits. At the same time, a lot of people approached emergency departments. As a result, many resources were misused. To promote shared responsibility and improve access to professional services “Massachusetts passed comprehensive health care reform designed to provide near-universal health insurance coverage for state residents” in 2006 (Keiser Family Foundation, 2012, p. 1).
Adoption of the Reform
The legislation of the state is based on a three-legged stool model. Thus, this very approach is used for the implementation of all reforms accepted by Massachusetts (Hirschikorn, 2012). Its healthcare reforms are not an exception.
From the very beginning, state legislators paid attention to non-group private coverage. It was targeted at the establishment of appropriate costs. As a result, a possibility to prevent price discrimination was obtained, and more people became able to afford insurance. Medical underwriting was also considered. Moreover, consumers received an opportunity to get insurance online, with the streamlined application process.
Minimization and extinction of unraveling were successfully achieved then. Trying to make a diverse population of the state equal, the government urged males and females over 18 years old to purchase health insurance or pay the penalty.
Finally, it should be mentioned that low-income populations received special coverage opportunities. They were provided with government subsidies that reduced insurance costs, making them more affordable.
A similar approach was used by Mitt Romney. This politician discussed health insurance in 2003. He attracted attention to the fact that a lot of representatives of Massachusetts’ population require this kind of coverage. Pointing out opportunities for improvement and letting the public acknowledge them, he developed separate reform bills. In 2005 already, they passed, and an appropriate law was adopted (Shapiro, 2015). This very alteration was used as a basis for a federal health reform created seven years ago. With its help, coverage was substantially expanded.
Funding Structure
Legislators of Massachusetts agreed with the majority of the bill peculiarities identified by Romney. Nevertheless, they faced issues when considering how they can be financed. The main problem identified by these professionals was that the implication of the healthcare reform could result in increased healthcare costs. Thus, they had to think of the most beneficial approach to finance the reform. It was decided that in addition to the consumers of healthcare services, employers and the government will deal with financing. As a result, a compromise was reached, and expenditures were shared.
Costs obtained through hospital assessments and covered levies were used to support the reform. About $320 million were provided initially (Van der Wees et al., 2013). Then federal safety-net payments and federal matching payments were added by the Massachusetts state legislators. Their actions allow allocating $610 million to the health reform. The MassHealth expansion was considered in this way. Moreover, the legislators expected to obtain almost $300 million due to the increased rates. Funds used in the financing of the health care reform in Massachusetts included $295 per worker that was to be paid by employers. Finally, the required money was obtained due to the Free Rider Surcharge (Kaiser Family Foundation, 2012).
Impacts
Massachusetts’ health reforms benefited the representatives of the general population greatly. Due to their implementation, a lot of citizens received an opportunity to obtain insurance. The most critical changes were observed right after the adoption of the research. During the first year, many people managed to experience positive changes developed with the help of the reforms. For example, in 2006, almost 11% of Massachusetts citizens did not have any health coverage. However, this situation improved significantly the next year, as only 5.5% remained uninsured. This positive tendency was observed until 2010 when a little bit more than 6% of the population had no insurance. Unfortunately, when the unemployment rate doubled, the distribution of health coverage altered.
In 2011 already, the majority of insurance options obtained by the general public were private group and employee-sponsored coverages. In particular, they comprised almost 80%. More than 15% were aligned with MassHealth. The rest of them were associated with Commonwealth Care and Choice. In addition to that, individual coverage was still considered. As a result, in comparison to 2006, more Massachusetts citizens received an opportunity to consult a doctor and have appropriate treatment (Keiser Family Foundation, 2012). What is more, coverage rates increased. Physician payment levels also altered positively, which affected professionals’ motivation. Thus, it can be proved that Massachusetts health reforms turned out to be advantageous for their stakeholders, regardless of the fact, that the issue of problematic access to healthcare services can be observed even today.
References
Hirschikorn, J. (2012). Massachusetts’ health care plan: 6 years later.
Keiser Family Foundation. (2012). Massachusetts health care reform: Six years later. Web.
Shapiro, A. (2015). Did Massachusetts health-care reform affect prices?