This Wellesley resident raised concerns with Senator Moore that the costs of health reform are going to adversely affect the resident and their spouse.  Correcting the resident, Senator Moore discusses the Legislature's role in containing health care costs through Chapter 305 of the Acts of 2008, and Senator Moore's efforts with the Affordable Health Plan proposal for small businesses. Read the exchange below:

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From: A Wellesley Resident
To: Senator Moore

Dear Senator Moore:

With all the buzz on health care reform on the national level, it seems that no one is taking a look at where reform is in Massachusetts 4 years in.

Here’s how it’s affected myself and my husband, who are both self-employed, and have always paid for our own plans. Since 2006, our cost has risen 130% for a lesser plan, higher co-pays etc. We just got the good news yesterday that this years increase is another 32%.

Reform? I’m frightened that we will be unable to continue paying, and frustrated that no one discusses the real-life impact on those who are REALLY paying for reform. Us.

We have finally reached the point where dropping our plan and paying the penalty may be our only option. Please know that we do not take this lightly. But we also don't take likely the fact that our hard work is paying for others without any regard for our well being.

I urge all involved to see this mandate for the failure that it is and investigate real reform in the industry.

Signed,

A Wellesley Resident

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From: Senator Moore
To: Wellesley Resident 

Dear Wellesley Resident:

Thank you for your assessment, but it’s really quite inaccurate as far as efforts to control costs. In fact, many people ARE taking a look, and taking action. Every objective study of Massachusetts Health Reform (Chapter 58 of the Acts of 2006 and its companion Chapter 305 of the Acts of 2008) demonstrates that rising costs are not the result of Massachusetts Health Reform. In fact, the two laws are already beginning to demonstrate that if they had not passed, the cost would be at least has high and quality would be less. 

Massachusetts health costs have not increased any higher than the national increase. The primary focus was to expand access and, by any measure, it has been an unparalleled success with 97.3% coverage. Quality improvement and cost control, because of the complex factors which drive both, take a little more time to achieve success.

If you have not done so, you might want to check into the Massachusetts Insurance Partnership which offers assistance for small businesses that are struggling to insure relatively low wage (below 300% of the federal poverty guidelines).

Massachusetts has made great strides in infection prevention – a statewide program initiated in C. 58 and expanded in C. 305 that is saving lives and money. The state is also investing in health information technology that has demonstrated it can save money and improve quality and a plan for statewide application over the next five years has been approved. The reforms established a Massachusetts Quality and Cost Council which has produced a plan to contain rising health costs while improving overall quality of care. The health reform law is reviewed constantly and, comprehensively on an annual basis and enjoys public support from 68% of the voters.

Most important, the reforms established a process to focus on rising health provider charges and insurance premiums and gave the Attorney General the authority to examine contracts and other documents to determine what is driving up costs. The Division of Health Care Finance and Policy and the Division of Insurance will hold a series of hearings beginning on March 16 with providers and insurers to require them to explain the reasons behind their cost increases and to determine ways to address those issues.

In the meantime, the Commonwealth Connector in cooperation with the Small Business Service Bureau is offering a new product for Small Business called “Business Express.” I encourage you to contact the Connector for more information on this new program. In addition, the Massachusetts Senate is developing a package of programs to help small business during this recession, including efforts to find affordable health insurance products for small businesses.

Senator Richard T. Moore

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From: A Wellesley Resident
To: Senator Moore

Dear Mr. Moore,

The costs I quoted in my letter to you were the “Business Express” plan offered through SBSB. To keep my premiums at the current level, I would need to accept a plan that is high in deductibles and carries co-insurance fees (35%) from diagnostic testing through hospitalization. Quality improvement? Not from where I stand.

We do not qualify for the Insurance Partnership.

What your response does not address is the mandate portion of Chapter 58. I did not need to be instructed to have coverage, we always did. And if the mandate was not in place, I would look out of state for a more suitable plan, perhaps catastrophic coverage only. But instead I am forced into high-cost, low-quality insurance products on the guise of improving access for all.

I understand that the primary focus was to expand access, but I also understand that coverage for all comes at a price. 68% support of voters? You might want to take a re-count.

With respect, and thanks for your timely response,

A Wellesley Resident

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From: Senator Moore
To: Wellesley Constituent

Dear Wellesley Constituent:

Thank you for the follow-up. The 68% voter support is not from state polling. It was from a professional polling firm hired by the Washington Post and conducted after Scott Brown's election. Obviously, you must be in the remaining 32%, and I believe we will continue to make progress toward improving quality and containing costs, but it has to be a continual effort. You are entitled to apply for a waiver from the individual mandate if you cannot find an affordable plan and to appeal if you are denied. I am continuing to work to find a solution for small business health insurance that's affordable.

Senator Moore

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From: Wellesley Resident
To: Senator Moore

Senator Moore,

I’m sure that the 68% satisfied have employer-based health insurance, and have no idea of the cost. If all had to pay out of pocket, as we do, I’m confident the satisfaction level would be different. Ignorance is bliss. And perhaps that’s the answer. Take health care out of the employment scenario.

As to the waiver, who determines what is affordable? The same people who ask me to pay $800 a month for insurance that requires a 35% co-pay for diagnostics and hospitalization? The system that calls that coverage? With apologies, I have little faith in a system that continues to ask me to pay more for less.

Thank you again for your response, and hopefully an objective ear.

A Wellesley Resident