1. Massachusetts Health Reform: Key Elements & Progress Jon Kingsdale, Ph.D. Executive Director November 2008

2. 2 Pillars of MA Healthcare Reform: Shared Responsibility Subsidize insurance for low-income uninsured (MassHealth & CommCare) Require individuals age 18+ to have health insurance, if affordable Require employers w/ 11+ FTEs to provide Fair Share Contribution & s.125 plan Reform the non-group insurance market

3. 3 Early Results: Decline in number of uninsured

4. 4 Commonwealth Care Subsidized coverage for adults not eligible for ESI, Medicaid, Medicare Household income at or below 300% of FPL Single person = $31,212 annually Family of four = $63,612 annually Their children qualify for MassHealth, free Shift funds flow from providers to individuals

5. 5 Commonwealth Choice Promote product choice Four target market segments: Young adults not offered ESI( ) Other non-group households( ) Employees not eligible for ESI( ) Small businesses Non-group market doubled in 9 months, half thru Commonwealth Choice

6. 6 Options Under CommChoice (37-year old Bostonian, July 2007) $184$248$257$278Bronze $256$303$380$372Silver $319$417$521$474Gold Carrier D Carrier CCarrier BCarrier A Benefit Level

7. 7 Plan choices for typical uninsured 37-year old Pre-reformPost-reform Monthly Premium $335$184 Rx coverageNone$100 deductible Deductible$5,000$2,000

8. 8 4. Employer Mandate: helps grow ESI

9. 9 Individual Mandate Politically acceptable (so far), if done right Source: Kaiser Family Foundation/Harvard School of Public Health/BCBS of Mass Foundation Surveys, 2006-2008