Square Peg, Round Hole

The state may have to step in and set health insurance rates if insurers are unable to create cheaper plans on their own to comply with Massachusetts' historic bid to expand coverage, a leading legislator warned on Wednesday.

"They need to get the message that they need to help us make this new law work," Sen. Richard Moore, D-Uxbridge, told the Boston Business Journal.

Let me see if I understand this.

The state issued the mandate.

The state set the benefit levels.

The state estimated the cost would be $200/person.

The carriers said the plan would cost closer to $380 per person.

Now the state is telling the carriers to get their pricing in line if they want to be a player.

You don't suppose carriers will simply refuse to offer coverage if they can't get their price?

Moore said his comments are a warning to insurers that some legislators and health care advocates will push for the regulation if the revised rates aren't affordable enough.

You WILL comply with our demands!

Yeah, right.

MA may have a bigger problem on their hands than they ever anticipated.

Initial proposals filed earlier this month by health insurers in the state carried an average cost of $380 per month for individuals who make above 300 percent of the federal poverty level.

The Connector Authority required the proposed plans cover at least a few doctor's visits not subjected to a deductible, and insurers say that state laws mandating insurance coverage of a variety of medical procedures will make it harder to come up with an affordable products.

Moore told the Boston Business Journal he envisions an "affordable" health plan having a monthly premium of between $250 and $280.


Same coverage as before but for 25% less premium.

Sure. That's going to happen.