Bay State groups press Congress on health care overhaul

Feb 23, 2010 — The Boston Globe

By Kay Lazar

Feb. 23, 2010 (The Boston Globe delivered by Newstex) --

Massachusetts labor, consumer, business, and health care groups urged yesterday that Congress break the gridlock on a national health care overhaul, saying legislation pending in Washington would help thousands more residents get coverage. But insurers blasted President Obama's newest proposal to give the federal government authority to roll back ``unreasonable and unjustified'' health insurance premium increases.

The proposal, which the White House released yesterday, is similar to a Patrick administration plan announced earlier this month aimed at easing escalating premiums for Massachusetts small-business owners.

Patrick wants to give state regulators the authority to cap insurance premiums, as well as the prices charged by hospitals, doctors, and other health services.

Under the Obama plan, health insurers would be required to submit proposed premium increases to state regulators for review, and, if a hike were deemed excessive, health insurers would have to ``lower premiums, provide rebates, or take other actions to make premiums affordable.''

The White House proposal contained few other details about how the process would work, except that it would include a new Health Insurance Rate Authority to provide oversight at the federal level, and to help states determine how to enforce their new power.

James Roosevelt, president and chief executive of Tufts Health Plan, said any proposal to cap insurance premiums, referring to the president's plan and the governor's, is a bad idea.

``Capping insurance rates without dealing with the underlying cost of health care is crazy,'' said Roosevelt, who is also board chairman of the Massachusetts Association of Health Plans, a trade group representing most health insurers in the state.

The state's largest private insurer, Blue Cross Blue Shield of Massachusetts, also opposes the plan, arguing that 90 cents of every premium dollar in the state goes toward medical costs and not to the insurer. Spokesman Jay McQuaide said the focus instead should be on reforming the way doctors and hospitals are paid, referring to a Massachusetts commission that last year recommended reining in costs by paying health care providers an annual lump sum for each patient, instead of a fee each time a service is provided.

But the Retailers Association of Massachusetts supports premium caps, said Jon Hurst, president of the 3,100-member group. A recent membership survey showed that the average annual premium increase since 2006 has been 15 percent, but this year's was 22 percent. And for some of the small businesses, premiums jumped 45 percent this year, he said.

The state's largest consumer group, Health Care for All, applauded the president's proposed regulation of rate increases, saying it would ultimately make health care more affordable.

``The president proposes to move us closer toward transparency,'' said Amy Whitcomb Slemmer, the group's executive director. ``That empowers consumers to make informed decisions about their health care choices.''

Slemmer was one of more than a dozen advocates who spoke at a State House rally, where supporters of a national overhaul said that Massachusetts' landmark 2006 health law has benefited thousands of its residents but that congressional action is still needed to help thousands more.

``It will make health care reform more affordable to 75,000 more families who are struggling'' to afford insurance now, Slemmer said.

The president's plan would offer help with health insurance premiums to families making up to four times the federal poverty level, which translates to $88,000 for a family of four. The Massachusetts law is not as generous, helping families with income up to three times the poverty level, $66,000 for a family of four.

Supporters said Obama's proposed tax credits for small businesses to offer insurance to their workers would help about 70,000 companies in the state.

And nearly 180,000 Massachusetts seniors would see discounts in their prescription drug costs because the plan would close the ``doughnut hole'' in Medicare coverage, supporters said.

Eva Millona, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said the president's plan is a good attempt at reaching compromise. But she said it contains no mention of benefits for legal, green-card-carrying immigrants who are unable to qualify for federal subsidies during their first five years in the United States.

``That is excluding millions of people,'' she said.

Kay Lazar can be reached at klazar@globe.com.

Newstex ID: BGL-1035-42281346