Massachusetts Democratic Gubernatorial Candidate Would Allow Uninsured To Get Coverage through State Employees’ Plan

Massachusetts Democratic gubernatorial candidate and former U.S. Secretary of Labor Robert Reich on Aug. 12 announced details of his health proposals, which he said would provide health care coverage to many uninsured residents and save the state $54 million to $118 million annually, the Boston Globe reports. A "key component" of his plan would allow uninsured residents to purchase coverage through the state's Group Insurance Commission, which insures about 265,000 state employees and retirees, at a rate "thousands of dollars lower" than private insurance. Reich also proposed expanding an existing disease management pilot program to include 600 severely disabled people and 10,000 Medicaid beneficiaries. Reich said the disease management program, under which nurses monitor Medicaid patients with multiple chronic conditions, could save the state millions of dollars each year. He also proposed increasing the state's bulk purchasing of prescription drugs, saving $64 million to $128 million; restoring Medicaid eligibility to 50,000 beneficiaries scheduled to lose coverage next year, costing $70 million annually; and providing care for 5,000 senior Medicaid beneficiaries in their homes rather than in nursing homes, saving $41 million annually. Reich said that his proposals represent the beginning steps in implementing universal coverage in the state. "I am committed to moving toward affordable universal health care when we can afford it, at a pace we can afford it," he said. Reich also criticized a health proposal outlined last week by Republican gubernatorial candidate Mitt Romney that would charge Medicaid beneficiaries copayments based on a sliding scale, saying that such a policy would discourage people from seeking preventive care and would increase health costs in the long run.

Fuzzy Math?
Several state officials and health care groups criticized Reich's proposals and questioned the savings of some programs. Dolores Mitchell, executive director of the Group Insurance Commission, said that adding uninsured people to the state's insurance pool would be expensive and labor-intensive. Other analysts added that because uninsured people often have a greater number of high-risk health problems, they would be unlikely to pay the same low-cost premiums as people currently insured through the plan. Michael Widmer, executive director of the Massachusetts Taxpayers' Foundation, said that restoring the eligibility of 50,000 Medicaid beneficiaries would cost closer to $200 million than Reich's estimated $70 million. Widmer added that the state has already largely implemented Reich's prescription drug bulk purchasing plan. Scott Plumb, senior vice president of the Massachusetts Extended Care Federation, said it is not fiscally sound to move many of the state's nursing home patients into home care because they require nursing services that can be provided for less money in an institutional setting. The Globe reports that gubernatorial candidate and state Treasurer Shannon O'Brien (D) plans to announce several health care proposals on Aug. 13 (Weiss, Boston Globe, 8/13).