BOSTON -- Coming up with affordable health care for the half-million Massachusetts residents who currently don't have it and can't afford it may not be easy, but Gov. Mitt Romney says state lawmakers should get the job done by the end of the year.
At a live New England Town Meeting broadcast hosted by NewsCenter 5's Natalie Jacobson Wednesday, Romney and state Sen. Richard Moore shook hands on a promise that lawmakers will work hard to come up with a system that addresses the needs of the state's uninsured by year's end.
Romney talked about the new health care legislation his administration unveiled Wednesday, and fielded questions from state residents who currently can't afford health insurance.
The governor said under the current system there are health insurance options for people who make substantial incomes and programs for the extremely indigent. The problem, he said, is there are few options for citizens in the middle.
"What we're looking to do is create insurance opportunities in-between to allow people to be able to make it and to be able to have an insurance product that they can afford," Romney said.
Romney unveiled his plan, labeled Commonwealth Care, earlier in the day. He said his goal is to provide cheaper health care coverage for the young and healthy and those working for small employers. The plan would allow about 204,000 people out of the current 460,000 uninsured in the state to buy health insurance, he said.
"It levels the playing field for individual proprietorships, sole proprietorships and small businesses," Romney said.
The governor estimates that a family of four could buy coverage for about $500, which is roughly half of what it costs today. The governor said no new taxes would be required, and no employer would be required to buy in.
"The problem is we have about 500,000 people who uninsured. They are in different categories, some are earning at a low level. They qualify for Medicaid, but there are some 106,000 people who qualify for Medicaid and don't know it. We are going out and signing them up and getting them insured. The other group is earning two times federal poverty, to three times federal poverty level. What they don't understand is when they made that extra little money they were no longer going to be qualified for Medicaid. It's not fair. We are creating a product called Safety Net Care."
Romney said Commonwealth Care will be for families earning up to $75,000. He said that the plan is to get everyone insured regardless of their income level.
John McDonough, executive director of the non-profit group Health Care for All, called Romney's proposal "a good start," praising elements such as making health care premiums tax-deductible.
He said, however, that he's concerned about employers with more than 50 workers who might dump coverage they currently offer in favor of new, lower-cost coverage the state might devise. Steve Booma, executive vice president of Blue Cross Blue Shield said that won't happen because bigger employers won't disadvantage themselves in as competitive a marketplace as Massachusetts because they compete to attract and keep good employees.
"The vast majority of employers in the state over 50 [employees] offer excellent health care through their plans. That's not where our problem is, our problem is under 50 [employees] and under 10 [employees] where people don't have the coverage or can't afford the coverage," Booma said.
One health care expert said part of the solution may be going directly to individuals rather than employers.
"One of the problems with trying to give subsidies to employers rather than individuals is people move from job to job, so by focusing on individuals, and focusing on their income and how much coverage they can afford, and making coverage more affordable to them, we are getting to the heart of the problem ... how we make coverage more affordable for low-wage workers," Andy Dreyfus of the Blue Cross Blue Shield Foundation said.
One woman in the Town Meeting audience reminded the health care industry officials and politicians that the Dukakis Administration tried to pass a comprehensive health care plan 20 years ago which was pulled off the books.
"As citizens, if we want to make sure that the promise is kept, and the laws that are enacted are kept on the books and fully-funded and fully-enforced, we need to take the next step, which is a constitutional amendment that guarantees every Massachusetts resident access to affordable, comprehensive health coverage, including prescription drug coverage," said Barbara Roop.
Sen. Moore said he is in favor of a constitutional amendment and voted for one in the past which would require ratification by state voters.
Romney said a constitutional amendment probably wouldn't be needed under his plan, which would ensure wider coverage and said if the state is going to consider one, he would want a breakdown of costs.
"What I don't want to do is tax our businesses out of being competitive and have jobs leave the state, or have people not be able to make it in Massachusetts," Romney said.
NewsCenter 5 Medical Editor Dr. Tim Johnson said eventually lawmakers may need to take a more radical approach to health care law.
"If we could eliminate employers as providing insurance and insurance companies, we'd eliminate a lot of wasted money," Johnson said. "What I'm really saying is that someday ... we're going to come to a single-payer system for financing health care, not for delivering it. And we're going to eliminate all the middle-men here so that individuals will have individual insurance, pure and simple ... It would be Medicare for all."
Romney disagreed with that suggestion.
"The idea that the only place that [people] could buy insurance is from the government would not make me happy," Romney said. "The idea that the government is going to be more efficient than private insurers is not, in my opinion, the answer for how to have good quality care ... thinking that somehow putting the Post Office in charge of providing our health insurance is not something I think America is going to be interested in."
Private health insurers concurred.
"Medicare and Medicaid have been underfunding health care on behalf of their beneficiaries for the better part of the last five years, and we and all the employers that we provide coverage to have been paying for that. And many of the things that people don't like fundamentally about the way the Medicaid program works aren't news. The Medicaid program's had holes and problems and seams and gaps in it since 1965," said Charles Baker, Harvard Pilgrim's chief executive.
Booma, of Blue Cross Blue Shield, said 93 percent of Massachusetts residents are getting health care from private employers, who pay 80 percent of the cost of the health insurance for their employees.
"If all of you who were clapping, with respect to having a single-payer system, just think about the fact that that 80 percent will be shifted to you as taxpayers. Is that something you really want to embrace? There is no free lunch. Someone has to pay it, and if it's not the employers paying most of the cost, and you paying some of the cost, it will be the consumers, taxpayers, paying all of the cost," Booma said.
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