Posts Tagged ‘national health care reform’

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Cross-coast Post: Real Choices

Thursday, June 10th, 2010

From our friends over at the Health Access Blog comes a great post about a California bill, SB890, that would implement many of the consumer protection pieces of national health reform early, like setting up strong medical loss ratios, so that insurers spend dollars on caring for people, not admin and profits, and creating minimum benefit standards in the private insurance market to help consumers make good comparisons. Here’s an excerpt:

By standardizing the benefits in the insurance market, consumers can make real apples-to-apples comparisons, forcing insurers to compete on price and quality rather than avoiding sick people. It ensures people know the kind of coverage they are buying, and what that plan actually covers. It prevents consumers from finding out too late that what their ailment isn’t covered. It prevents the worst forms of “junk” insurance, where patients are paying premiums and finding little value in return.

Read the rest of the post about how standardizing benefits allows for real choice at the Health Access Blog.

–Kate Petersen, Health Policy Hub

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The Insider: Implementation Nation

Tuesday, April 20th, 2010

Although the national media spotlight has moved on, the work of health care reform is only beginning. Today we  look at some of the recent developments in Massachusetts—which is sort of a health reform “beta site”—and what they tell us about reform in the rest of the country. We’ll also examine one of the early implementation provisions: the temporary high-risk pool.

Massachusetts: The gift that keeps on giving

Throughout the debate on national health care reform, Massachusetts has played an outsized role. The bipartisan nature and popularity of reform in the state, its success at reducing the number of uninsured, and the prominent role Massachusetts pols from both parties played in the national reform saga have all helped to make what happens in the Bay State unusually significant. This is likely to continue to be true going forward.

Because Massachusetts is farther down the implementation path, it has already encountered issues that will come up in other places. Three recent developments in Massachusetts highlight the state’s continuing relevance to the reform debate.

The first is the controversy over insurance premium rate hikes.  Earlier this spring, the Massachusetts Division of Insurance denied dozens of premium rate increases as being excessive. (See the Boston Globe article.) The ruling led to a court challenge by insurers and a brief insurance “strike” as Massachusetts insurers took their plans off the market.  (Since the court refused to grant the insurers a preliminary injunction most plans are again available). Although this preliminary ruling went against the insurers, there is no guarantee about the final outcome.

The takeaway? Insurers will play hardball to resist downward pressure on premiums. States need strong tools and political will to fight back. An effort to beef up premium oversight had to be stripped from the final national health reform bill because it did not fit within the rules of the budget reconciliation process, but a stand-alone rate regulation bill is being championed by Sen. Diane Feinstein. A hearing is scheduled for this Tuesday in the HELP committee, but odds of passage are uncertain, since it’s likely that Republicans will present a united front in opposition, making it hard to get the necessary 60 votes.  In the absence of federal authority,  advocates may want to turn their attention to strengthening state oversight.

A second issue to hit the Boston media recently also has lessons for national reform. Insurers allege that there is a group of people taking advantage of continuous open enrollment to purchase non-group insurance for a short period of time, schedule costly medical care, and then drop out. Like so much of national reform, this claim comes with a heavy dose of politics attached, since the charges are being made by a former insurance industry exec who’s running for governor.

These “short-stayer” allegations have yet to be substantiated. So far insurers have not provided data which shows what medical care alleged short-stayers are using, whether or where they were previously insured, and whether the problem is growing or actually diminishing. The Division of Insurance is studying the issue and its report is expected soon.

Meanwhile, we can and should expect insurers to fight to undermine the impact of guaranteed issue by narrowing access to insurance. This battle will be fought first at the federal level as HHS determines the initial and subsequent enrollment periods, and it’s critical that consumers push back to make sure that insurance remains as accessible as possible.

The third implementation issue in Massachusetts with implications for the states is one that has received no media attention (and was not heeded by federal lawmakers during the debate): When it comes to helping people make informed choices among competing insurance plans, standardizing actuarial values is simply not enough.

Within any given benefit tier (gold, silver, etc.), insurers can vary cost-sharing arrangements so much that comparison remains difficult. Focus groups in Massachusetts show what those done by national organizations do: What people want is better choices, not an infinite number of choices. And so after several years of experimenting with actuarial value, the Massachusetts Connector has moved to standardize benefits. Federal law does not require states to create standard benefits, but it does not prohibit it, either. Nor is there any reason that standardization has to wait for the 2014 kick-off of health insurance exchanges.  Advocates should consider pushing for greater standardization in their state markets now.

High-Risk Pool rules present states with tough decisions

One of the first provisions of national health care reform slated to be implemented (90 days after passage) is the creation of a temporary high-risk pool (HRP) for those excluded from coverage due to a pre-existing condition. As welcome as this new program is, given that most existing state high risk pools perform poorly, it may prove difficult to effectively integrate the new program with existing state law.

PPACA establishes a set of rules for both the federal HRP and any existing state pool that wants to tap into the $5 billion in federal support made available by health reform.  These rules include setting a minimum actuarial value and out-of-pocket maximum for HRP coverage. They also prohibit the imposition of pre-existing condition exclusions, require rates to be the same in the HRP as in the market generally, and set a limit on age rating of no more than 4-1. All of these are welcome changes.

However–and it’s a big however–federal law also restricts eligibility for the HRP to those who have been uninsured for at least six months. While this provision is designed to prevent people from dropping existing coverage to enroll in the federal plan and to help stretch federal dollars, it also creates some problems. Consider these four types of states:

States with no HRP and no guaranteed access to insurance in the non-group market–For these states there is no problem: Either the state will set up an HRP that meets federal standards, or the federal government will set up a pool on behalf of the residents of that state. End of story.

States with an HRP that is worse in all respects to the federal law–A state could “true up” its program to meet federal requirements, or it could do nothing, in which case the federal government would set up a parallel program.

What happens then? Everyone with a pre-existing condition (who can afford the premiums) can enroll in the federal program except those who are already enrolled in the state HRP. They either have to take the risk of going without coverage for six months, or remain locked into inferior and costlier coverage in the state pool.

States with an HRP that does not require a six-month wait–Even if a state pool is as good as or better than the federal requirements in most respects, the requirement for a six-month waiting period could create problems.

In general, states can run a program that is better than the federal program if they choose. But, if states do not impose a six-month waiting period, their program will not qualify for federal assistance.So they have the choice:   either impose a new access restriction on people with pre-existing conditions, or set up a parallel pool (or allow the federal government to). In the latter case, those who can take a chance on going without coverage for six months could join the federal pool, while those who could not would retain or join the state pool, leading to a generally sicker pool of enrollees in the state pool.

States that already have guaranteed issue and modified community rating in their non-group market–A number of states, including New York, Maine, Vermont and several others have already eliminated pre-existing condition exclusions instead of having a high risk pool. However, because of the six-month no-coverage requirement it’s unclear if these states would benefit at all.

Regulations for how states should implement the HRP provisions are expected very soon from HHS, but it’s unclear whether the Secretary has the authority to address these problems, or if the solution requires a Congressional fix.

Coming next time: Repeal Watch!

–Michael Miller, director of strategic policy

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How sweet it is

Monday, March 22nd, 2010

The U.S. House of Representatives passed the most comprehensive health care bill since Medicare last night–a bill that provides health care coverage to 32 million more Americans, ends decades of unjust health insurance practices that discriminate against those who get sick, and curbs runaway health care costs.

The President is expected to sign the bill tomorrow, and the Senate will begin debate then on a series of fixes to the bill. There is–as always–more work to be done.

But today we thank the Representatives who crafted the bill, who stood in support of reform and took the votes, all their “punk staffers” who have worked without weekends and sleep for the better part of a year (and some for much longer), and all of the reform advocates for their tremendous, sometimes Atlas-like work in helping to pass this bill.

(Here is Community Catalyst’s official statement, and what you need to know about reform right now. And if you don’t follow the Hub on Twitter yet, get on board before the Senate debate begins.)

When it comes to reflecting on What This Means — in history, yes, but also in plain English — there are few who said it better than Michigan Rep. John Dingell, who’s father, John Dingell Sr., gaveled in Medicare in 1965 (and who lent that historic gavel to Speaker Pelosi for the vote last night.) Here’s what he said after the vote last night:

I gotta tell you, the air has been redolent with falsehoods and deceit. And Madame Speaker persisted clear through this, and my colleagues stuck. And nobody ran when the heat got high.

And I want you to know I am very proud of this leadership and of my colleagues, and of a lot of new members who made some very hard and difficult votes,  for which they can be proud, and for which they will be rewarded with re-election, because they showed courage and wisdom. And they did something that was very important.

But dear friends, there’s something else. Now when Americans lose their jobs, now when Americans go to bed, they won’t have to worry when they get up the next morning: Are they going to have health insurance?

We have established a basic principle now–finally–in a bill that is going to the President to be signed–that says  health, and good health, and health insurance, and health care, are not a matter of privilege for the privileged few, but rather they should  be for everyone.

And the government has finally decided we’re going to take care of that.

–Kate Petersen, Health Policy Hub

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And now, the moment you’ve all been waiting for

Tuesday, March 9th, 2010

For months, various parties have been calling on the President to clarify exactly what he was for and, following the loss of a 60-vote majority in the Senate, how he thought that could be accomplished. Starting with the run-up to the Feb. 25 summit, President Obama did just that, laying out a package of amendments to the Patient Protection and Affordable Care Act passed by the Senate and calling last Wednesday for an up-or-down vote on health care within the next few weeks.

The President’s proposal would improve on the Senate bill by toughening oversight of the insurance industry, improving benefits and affordability provisions and closing the Medicare part D doughnut hole. He also added several Republican ideas from the summit such as new proposals to reduce payment errors in Medicare and Medicaid.

In a surprise to many, the RNC called on Groucho Marx to deliver their response.

OK, just kidding. What was striking about the real response from Congressional Republicans was the way they resorted to invective. Away from the Blair House setting—where they could be directly challenged for “having their own facts”—they reverted to much harsher language than they used in the largely civil exchange during the summit. “Job-killing“(Independent analysts say health reform will promote job growth), “budget-busting” (the CBO says that reform will reduce the budget deficit by about $100 billion over 10 years and by $1 trillion over 20 years) “government takeover” (people get a choice of private insurance plans) were some of the greatest hits from the last week in sound bytes. Oh, and of course the ubiquitous “jam” that Jon Stewart spoofed last week (video at 2:20).

Despite the fact that the Senate bill that is remarkably similar to the one that Republican moderates were advancing in the 1990s, today’s Republicans have made it clear (through this RNC fundraising presentation, among other things ) that polarization and fear-mongering are central to their campaign strategy. No wonder no bipartisan health care compromise has been possible.

This fact-resistant extremism could be a factor that helps clear the way for final passage. Another other is a series of highly visible double-digit premium increases that are being proposed across the country, especially in the non-group market. The lack of any insurer accountability has been a stark and timely reminder of the need for change.

Here to there: the New new timetable
Deadlines have come and gone more than once while the health reform debate has dragged on. We now have another schedule for action, albeit a tentative one. The administration is hoping to have a reform vote in the House by March 18, just 11 days from now, and hopes that Senate action will begin prior to the spring Congressional recess, which starts March 29.

The first vote is the hardest
Although the challenges of using budget reconciliation have drawn the most attention from commentators, the hardest step in the process from here on out is the first vote in the House. Although subsequent action will address many of the problems House members have with the Senate bill, the path forward requires the House to vote first for the Senate bill as-is and then vote to fix it—something that many House members have expressed reluctance to do.

Abortion contortion
Probably the House leadership’s biggest stumbling block to assembling a majority is dealing with the abortion issue. In the initial debate in the House, Democrats who opposed choice were joined by Republicans to put in very restrictive language, authored by Congressman Bart Stupak, that many feel will eliminate abortion coverage within the Exchange and may undermine private coverage for abortions in employer-based plans.

According to an analysis by Faith in Public Life,  the language in the Senate already precludes federal funding of abortion.

However, Congressman Stupak has argued that the Senate language is not strong enough, and has declared his intention to vote against the Senate bill, claiming that about 10 other Democrats will join him. Given the very narrow margin of victory in the House, every Democrat beyond Stupak who switches from yes to no because they don’t like the Senate abortion language (or for any other reason) must be offset by switching the vote of someone who voted no the first time to yes the second time.

Facts not worth a hill of beans?
Although it seems his vote is pretty fact-resistant, it appears that Congressman Stupak is misreading the Senate language.2352670827_dc9563c0c3_m

The Senate bill, as best as I can tell, does not allow federal funding of abortions—despite Rep. Stupak’s insistence that it does. And we don’t have to take either Speaker Pelosi’s or the pro-choice community’s word for it. If the Senate allowed federal funding of abortion, then presumably the matter could be addressed in an amendment that would pass through budget reconciliation—an amendment Rep. Stupak would undoubtedly bring.

But there is no such amendment on the table. Why? Because amendments through budget reconciliation must impact the budget, and there is no budgetary implication in the difference between the Nelson and Stupak abortion language. Although there is no public document available, this appears to be the view of CBO.

Remember: the CBO is neither pro nor anti-choice in this debate. They are simply the bean counters. And if they say there are no beans on the table to count that should count for something–if not to Congressman Stupak, then at least to other Congress members who oppose abortion rights as a matter of conscience or religious conviction.

Smooth sailing?
Once a bill does clear the House, the road to reform becomes smoother (not quite seat-belt sign off, but smoother). Although Republicans have threatened to delay the vote in the Senate by filing endless amendments and launching parliamentary challenges, this is as much a psychological game as anything else.

Senate Republicans are trying convince some members on the House side not to take that first vote, playing on the fears of House members who worry that the improvements they’ve agreed to won’t happen and the House will be stuck with the unamended Senate bill. But once the House does vote, the dynamics change. Then the choice is no longer health reform, yes or no, it is health reform as passed by the Senate or health reform with the proposed amendments.

By opposing the amendments to improve the Senate bill, Senate Republicans risk exposing themselves as flip-floppers, voting for policies they previously opposed (such as the special Medicaid funding for Nebraska, and the special excise tax provisions that apply to union-negotiated health benefits) in an attempt to score political points. [I talked about this here last week.]

–Michael Miller, director of strategic policy

photo credit: base10 on flickr

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One year on

Friday, March 5th, 2010

A year ago today, President Obama gathered Congressional leaders, providers, advocates and industry leaders at the White House to start the conversation about health care reform. “The status quo is the one option that is not on the table,” he said then.

And a year later, it’s still not. Millions can’t afford coverage and millions more can’t afford to get sick on the coverage they have. An industry that has profited by exploiting health circumstances that are often beyond people’s control is flaunting 40 percent rate hikes, reminding us that the only people it answers to today are shareholders.  So the status quo is—well—the same.

But we aren’t where we started. In a year of extensive committee hearings, votes and record hours spent working and reworking bills, Congress has crafted a reform that offers coverage to more than 30 million uninsured, allows more people to buy into the private insurance market, and provides help to those who can’t afford it, a reform that prevents companies from denying coverage or sending families into debt spirals after costly procedures, a reform that improves the way we deliver and pay for care in this country – and that pays for itself completely and sustainably. Both chambers have passed such a bill. We are this close.

There are other things that are different a year on. Since the first convening last March and the summer’s glimmer of bipartisan negotiation, Republicans have made a political calculation that though the bills pay for themselves and would offer much-needed help to many people in their districts, they plan to vote against any and all efforts to pass comprehensive health reform.

And after deliberately standing aside to allow Congress to drive and shape reform – (”I just want to make sure that I don’t get in the way of all of you moving aggressively and rapidly,” President Obama said last March) – the President made it clear Wednesday he’s not standing aside anymore.

“Both during and after last week’s summit, Republicans in Congress insisted that the only acceptable course on health care reform is to start over. But given these honest and substantial differences between the parties about the need to regulate the insurance industry and the need to help millions of middle-class families get insurance, I do not see how another year of negotiations would help. Moreover, the insurance companies aren’t starting over. They are continuing to raise premiums and deny coverage as we speak. For us to start over now could simply lead to delay that could last for another decade or even more. The American people, and the U.S. economy, just can’t wait that long.

“So, no matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform….and from now until then, I will do everything in my power to make the case for reform.”

Transcript’s end, he stepped away from the mic and said into the applause:  “Let’s get this done.”

–Kate Petersen, Health Policy Hub

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UPDATE: You put the right bill in, you get the right vote out

Tuesday, March 2nd, 2010

(Please see corrected link below)

It’s not about the process
With the summit behind us, the press has returned to obsessing about (and misconstruing) the process by which health reform might move forward. So a few important clarifications are in order.

First, health reform will not pass via reconciliation.  Comprehensive health reform will pass as part of the normal Congressional order via a majority vote in the House of Representatives (more on that vote in a minute); having passed the Senate with a super-majority of 60 votes.  House Republicans will have one last chance to vote on this package and nearly everyone assumes that they will unanimously vote no.

What will also pass–by majority in both the House and Senate–are amendments to that bill.  Those amendments, as outlined by President Obama, would do a number of important things: They would increase and equalize federal Medicaid payments across states, provide low- and moderate-income families with better benefits and/or premium subsidies, close that Part D “doughnut hole,” make the excise tax on high-cost plans fairer, and provide tougher oversight of health insurance premiums.

The question that will come before Congress will be on these amendments.  And here’s what the media should be spending more time on: If Republicans vote no in a block, they will be voting for the “Cornhusker kickback” and against more Medicaid dollars for their states.  They will be voting against improving coverage for seniors with multiple chronic conditions  They will also have to cast a vote that makes it clear whether they stand with regular people or insurers on the issue of premium rate hikes. If we focus on substance over process, then voting for a package of fixes to the Senate bill should be a great vote for supporters of reform, and a tough vote for opponents.

About that vote
The President is expected to offer more specifics on the path forward later this week (probably Wednesday, so check in then for our update). But by now, it seems clear that the Republicans have no interest in tighter regulation of the insurance industry or a major effort to cover the uninsured—and Democrats have no interest in scrapping these elements of reform and starting over.  So we can expect a party-line vote going forward.

There has been a lot of media speculation about whether the votes are there for reform in the Democratic caucus in this scenario. Although it’s impossible to do a real vote count before a package of amendments is agreed on, both branches seem close to having the majorities they need.

Much of the recent speculation has centered on the House, where the challenge will be to find a sweet spot that will satisfy both Blue Dogs and Progressives, avoid too many defections on the abortion issue, and also attract 50 votes in the Senate.

Does that sweet spot exist?  Speaker Pelosi and Majority Leader Hoyer believe the answer is yes, and have reiterated their commitment to passing reform. And the House leadership team has so far shown an uncanny ability to move difficult legislation through the House, so betting against them would be unwise.

The final votes in both chambers may be close, and certainly an all-out effort from the grassroots will be needed, (so sign this petition to send a message in support of comprehensive reform and forward this link to your friends and networks too.)  But as we enter the homestretch of the health care reform debate this year, there is good reason for optimism.

About that status quo
Instead of focusing on the intricacies of Congressional procedure and speculating about the vote count, we need to focus on why reform is necessary.  To that end, the Urban Institute is out with a new issue brief that shows just who loses if health reform doesn’t pass.  The biggest losers (out) are older adults, people with pre-existing conditions (and many of you know firsthand just how big a group insurance companies have made that), small businesses and their employees, low-income households  and young adults. These are the groups for whom the current dysfunctional system works least well, and who will be most at risk of being priced out of coverage if reform doesn’t pass.  But ultimately, the Urban brief points out, improvements in security and stability of coverage, and in the quality of care people get, will benefit everyone.

And that’s what it’s all about.

–Michael Miller, director of strategic policy

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Insider Update: Summing up the Summit

Friday, February 26th, 2010

After seven hours of debate, parties agree to disagree on whether they are close to agreement

As expected, no new consensus emerged yesterday from the seven plus hours of debate between top Congressional Democrats and Republicans and the President about what was wrong with the nation’s health care system and how to fix it. Despite the Democratic mantra that “we’re not that far apart,” what did emerge was greater clarity about exactly where the differences lie and why they cannot be bridged.

First, there is a fundamental difference between the parties on the issue of how to address problems in the health insurance industry. The proposal being advanced by President Obama and Congressional Democrats contains a strong program of insurance reform including:

  1. Eliminating pre-existing condition exclusions
  2. Setting minimum standards for coverage
  3. Requiring insurers to spend at least 80% of the premium dollars they collect on health benefits
  4. Prohibiting insurers from charging people more because they are sick (or because they are female) and limiting variation based on age
  5. Increasing the ability of state and federal regulators to block excessive and unjustified rate increases

In stark contrast, the proposals advanced by Congressional Republicans would give insurers increased ability to create pools of healthier enrollees, which would lower costs for some but would result in higher premiums for people who are older or sicker.

Anyone? Anyone?

The second major difference is on coverage. According to the Congressional Budget Office, the president’s plan would reduce the number of uninsured by more than 30 million people while the ideas offered by Republicans would insure only around three million (Community Catalyst’s latest paper explores these issues). The President might as well have been the teacher in “Ferris Bueller’s Day Off” given the deafening silence that followed when he asked if there was any way the Republicans could see themselves moving beyond the minimal coverage expansion in their plan.

At the close of the summit, President Obama offered to continue the dialog with Republicans but with the precondition that they rethink their position on these two key issues. House and Senate Republican leaders were quick to decline the invitation, leaving only one path to real reform: Democrats in Congress have to come together to pass a bill by majority vote; the sooner the better.

Moving Right Along

Over the next few days House and Senate leaders will need to consult with their members and with each other to lay out the parliamentary path forward. This “inside baseball” will have to get worked out by the House and Senate leadership and the White House. What matters most is not the sequence, but the outcome.

Keep fighting the good fight

Advocates need to continue to make the case for comprehensive reform. You can help by signing this online petition that is being sponsored by the American Cancer Society/ Cancer Action Network, Community Catalyst, and many other national organizations:
www.healthcarepetition.org/10707_communitycatalyst

-Michael Miller, director of strategic policy

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State business, health care, labor and faith leaders call on Massachusetts delegation to pass national health care reform

Monday, February 22nd, 2010

A diverse group of leaders joined together in the Massachusetts State House today to deliver one message to the state’s delegation: National health care reform is anything but a raw deal for Massachusetts.

The 16 speakers representing faith groups, advocates, consumers, small business, providers, insurers, labor, immigrants, seniors and government called for Congress to move forward on comprehensive reform now. And they asked the Massachusetts delegation especially to support their constituents by voting yes on national reform.

“This is the social justice issue of our lifetime,” said Rabbi Jonah Pesner, leader of the Greater Boston Interfaith Organization. He added that the state’s 2006 health care reform had expanded coverage to hundreds of thousands of individuals, and he hoped for the passage of national reform to help “continue gains in Massachusetts.”

Even while the state’s reforms have helped insure 97 percent of residents, gaps persist, said Amy Whitcomb Slemmer, executive director of Health Care For All, a health advocacy organization (and Community Catalyst’s sister organization). “Too many people still can’t afford coverage. We need to work to close that gap.”

National reform would accomplish that by offering subsidies to 75,000 middle class families to help them afford quality insurance. Reform would also support businesses that now struggle to offer health care to their employees.

“For my business to grow and thrive, we need healthy workers,” said Phil Edmundson, CEO of William Gallagher Associates. “National health reform would provide tax credits to help small businesses offer coverage, allowing them to create jobs and grow our economy. An estimated 70,000 small firms in Massachusetts would benefit, and our economy and health would improve.”

Speaker after speaker emphasized that reform at the national level would not only provide more state residents with affordable care and help fund Massachusetts’ own reform, but it would also improve health care across the country and give those in other states the quality coverage and opportunities that Massachusetts now enjoys.

“The physicians of the Commonwealth not only support the pioneering effort here in Massachusetts, but we know that it’s going to lead to national health reform that will improve the quality and safety of care,” said Dr. Jack Evjy of the Massachusetts Medical Society. “National reform will further expand coverage so that we’re taking care of all of our sick people, and that’s an important thing for America.”

The state’s health secretary, Dr. Judy Ann Bigby, called on the Massachusetts delegation to do what’s best for Massachusetts – and for the country as a whole – by voting for national health care reform, just as they supported the state’s successful reform four years ago.

“Health care is a right, not a commodity,” she said. “It’s time the richest country in the world provided health care to everybody in the United States.”

See videos of the event from Health Care For All: http://www.youtube.com/user/HCFAMA

-Elizabeth Ress, Health Policy Hub

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What we talk about when we talk about Massachusetts

Friday, February 12th, 2010

Scott_P._BrownAs we’ve said here before, the Senate special election in Massachusetts was a lot of things. One can probably find a hundred different explanations for why Scott Brown won in a hundred different bars on a given five o’clock (though we’re not advocating this polling method.)

But there’s hard evidence that whatever else Massachusetts voters were saying, they weren’t saying stop national health reform. Despite our convincing case, the national media kept saying the election was a referendum on health care reform. We kept looking at the polls, which said otherwise. So we’re taking the old statistician’s route: Say it again, with numbers.

The Massachusetts special election was not about health reform.

For voters, the economy came first. Seventy-nine percent of voters said their first priority was to “strengthen the economy and create more good jobs.”

And though 82 percent of voters said they knew of Scott Brown’s position to oppose national reform, this was a wash — just as many said this made them more likely to vote for him, as said it made them less likely to vote for him. (No one said Bay Staters were an easy crowd to figure out.)

And perhaps most tellingly, a majority of both overall voters Brown supporters (including Brown himself) supported Massachusetts health reform – a law that has achieved 98 percent health insurance coverage and served as a model for the national bills passed by the House and Senate. That’s powerful stuff: Opposed to many commentators who have the freedom/burden of conjecturing what reform might do, Massachusetts residents are living with the changes reform made and is making everyday – and they’re pleased.

Hungry for more proof? Check out our fact sheet.

–Kate Petersen, Health Policy Hub

photo credit: Wikimedia Commons

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The Point

Tuesday, February 9th, 2010

While we were encouraging folks to write letters to local newspapers, telling stories about what health care reform means for people they know, we realized each of us here knows someone who would be helped by health reform passing.  Who reminds us that words like premium subsidy, out-of-pocket maximums and minimum benefit standards actually stand for other words: friend, parent, child, colleague.

So this week we begin to share why we’ve been drinking so much office coffee this past year, and spending more time connecting with the Congressional switchboard than with our families.

The first story is from Ann Rudy, a field coordinator here.

My mom, who is 60, works as a hairdresser in Texas. Her employer does not offer insurance to employees so my mom and her husband, who is self-employed, purchased policies on the individual market.  She has worked since she was 16 and has always been healthy.  Like many without an affordable insurance option, she rolled the dice when she purchased a high-deductible plan.  Unfortunately, she lost.

Several months later, my mother fell. By the end of the day, she was in pain and was having trouble moving one of her legs.  She thought she could ‘walk it off,’ but eventually she went to the ER in pain. She had shattered her hip.  After major surgery and a hospital stay, my mom is now chipping away at her $10,000 credit card bill.

National health reform could prevent this from happening to others, or to my mom again. Small businesses like my mom’s salon would get tax credits for offering insurance to their employees. And if they didn’t offer an affordable insurance option, she would be able to shop for a plan in the insurance Exchange, where companies would be required to make clear what a plan covers and how much it costs. (In Texas and other states, no such requirement exists right now.) My mom might have qualified for new subsidies to help with her premium and out-of-pocket costs. And new rules in the federal bills would set limits on out-of-pocket expenses, so someone who falls sick—or a healthy person who takes a fall—would never be asked to pay $10,000 of her medical costs from her paycheck, or on her credit card.


If you have a story to share about how health care reform matters to you, please email us at hub@communitycatalyst.org.

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