Massachusetts health reform has expanded employer-provided coverage, improved quality
Contrary to previous concerns, employers have not dropped coverage or reduced benefits under Massachusetts' 2006 health care reform law, according to the results of a study published in the October 1 online issue of Health Affairs. Instead, as of the fall of 2008, the rate of coverage through employers had risen and the scope and quality of coverage also improved, even among small employers (those with 50 or fewer workers), the researchers from the Urban Institute noted. However, workers' premiums and out-of-pocket costs have become an issue for workers at small firms, although this does not seem to have negatively affected participants' access to needed medical care.
Among the Massachusetts health care reform requirements, employers were to establish an IRC Sec. 125 cafeteria plan to allow employees to pay health insurance premiums on a pretax basis, and employers with more than 10 employees must make fair and reasonable contributions toward workers' health insurance or pay a $295 assessment per full-time equivalent worker per year.
The state also merged the individual and small group health insurance markets and established minimal creditable standards for health insurance to meet the individual coverage mandate. The minimal creditable standards require a comprehensive benefit package, including mental health and substance abuse services, prescription drugs and a maximum on annual deductibles and out-of-pocket spending, among other provisions.
In the fall of 2008, the share of workers with Sec. 125 medical flexible spending accounts rose by 9.1 percentage points to 28.5 percent for all workers, and by 8.4 percentage points to 20.5 percent for workers at small employers.
A recent national study, which used simulation methods to examine trends in the comprehensiveness of coverage and out-of-pocket spending, found declines in the former and increases in the latter (including premium costs) for U.S. adults with employer coverage between 2004 and 2007, the researchers pointed out. In Massachusetts, coverage is comprehensive, as required by the reform law, and premiums and out-of-pocket costs rose mostly for participants in small group plans.
The higher costs are a reflection of increasing health care costs overall, the expansion of covered benefits and higher premiums for small employers due to the merger of the individual and small group insurance markets, the researchers explained.
The article, Massachusetts Health Reform: Employer Coverage from Employees' Perspective, is available at http://www.healthaffairs.org.
Reprinted with permission. © CCH
(Submitted Oct. 15, 2009)
<p>Massachusetts health reform has expanded employer provided coverage, improved quality Contrary to previous concerns, employers have not dropped coverage or reduced benefits under Massachusetts' 2006 health care reform law, according to the results of a study published in the October</p>
Massachusetts health reform has expanded employer-provided coverage, improved quality
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