Thursday, May 11, 2006

Under the Mass Microscope (Part 1)

Eight years ago, when Kennedy-Kassebaum (aka HIPAA) was being hammered (and subsequently rolled) out, a colleague and I downloaded and read the entire legislation (which, IIRC, ran some 200+ pages in a pdf file).
While everyone else was touting guaranteed issue, and portability, and even viaticals, Ray and I noticed something other things: NPI, and PHI, and other less than savory components.
We predicted that HIPAA would, ultimately, create at least as many problems as it purported to solve. And, ultimately, that seems to be the case.
So now we turn our attention to the oft-cited, but apparently less well understood, MassHealth insurance reform plan now being implemented in the Bay State. As is our wont here at IB, we’re going to look at some of the items that are currently “under the radar,” but which could very easily become profound. And, unlike some blogs, we won’t rely on the news media’s interpretation of “what it all means,” we’re going to be working strictly from the law itself.
■ To subsidize the purchase of private insurance for low-income individuals
■ To reduce the number of uninsured
■ And to direct more federal and state dollars to individuals and less to institutions
Lofty and laudable goals, to be sure, but are they the least bit realistic?
Well, let’s see.
The very first piece is about low-income folks. But many (most?) are already covered by Medicaid. So this is just good old-fashioned cost-shifting, or perhaps that should be “shafting.” And a lot of other folks choose to go “bare.” What happens to them?
Almost a year ago, when this plan was embroyonic, I asked “where are the teeth?” Well, we got ‘em: introducing the “Health Insurance Responsibility Disclosure” form, “to be completed and signed, under oath, by every employer and employee doing business in the commonwealth,” failure to comply with which “may be subject to sanctions under chapter 111M.”
Whatever that means (but it probably isn’t fun).
Believe it or not, there’s more. Click for Part 2.
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