The Massachusetts Health Reform Act has captured the minds and attention of all residents of the United States. Its main goal is to achieve universal health insurance coverage and controlling costs and payments. The Massachusetts bill was enacted in 2006 by the initiative of the governor Mitt Romney, who contributed a lot in the implementation of health reform into life. New initiatives were considered by Congress and were supposed to provide regulation of health insurance in public and private sector, expansion of Medicaid and Commonwealth care. Massachusetts became the first American state offering health insurance coverage to all its residents. The Massachusetts Health Reform is in progress now, and implementation faces many challenges. State officials and health care professionals continue to advance this reform in cooperation with business community (Turner & Persico, 2009). The present Massachusetts governor Deval Patrick made a great contribution into implementation of all initiatives into reality. In present, this health reform plan is developing and observers are cautious about the outcome. Due to the Massachusetts health reform, many changes have been observed in the health care insurance system.
Health Care Access
Changes taking place in the American health care system today are evidently the main reason of adoption of the Massachusetts Health Care Reform Act, which aims to improve the quality of health care in the state and keep under control costs by reforming health care system and payment. Research reports that many patients are dissatisfied with the quality of their healthcare services, such as health plans (Long, 2008). Doctors, on the other hand, are also worrying about the improvement of the services they are providing to the patients.
Massachusetts choseto pass this legislation because of lack of health insurance. The changes were needed in order to protect the Medicare program and make it more fiscally sound. Consumers have no guarantee that they will be able to receive quality care, regardless of what kind of that care it could be and where it is provided. The future improvement of health care services requires a number of proper strategies, which could provide serious changes in health system and the development of the infrastructure. Research reports that the Massachusetts Health Care Reform Act became law in April 12, 2006. It was signed by the former Gov. Romney and continued to succeed by the present Gov. Patrick. Massachusetts authorities are relying on the federal government and its support.
Press reports that the act will allow consumers to receive more qualified health care assistance on the cost-effective basis, as well as give the opportunity to the health care industry to provide new effective innovations with the aim to deliver better health care services to the patients and control costs by reforming health system and payment (Patrick, 2011). According to research, when the U.S. Supreme Court began to uphold the federal health reform, employers in Massachusetts had certain uncertainties about it. That is why the 2006 Massachusetts version was created. The employers are worrying about the millions of dollars that are at stake. They acknowledge that there is a need to set up two separate sets of regulations for state and federal reforms (Blum, 2011). The bill of 2006 made the Commonwealth of Massachusetts the first American state, which can ensure access to health care for all its residents. High quality care has become a reality.
How to Accomplish the Goals
The state regulators and authorities start to iron out the differences between the federal and state reforms. The research reports that in order to improve Massachusetts health care system, the federal and state governments, health care providers, insurance companies and stakeholders must work together (Patrick, 2011). Thus, the act is supposed to accomplish all problems and complexities in order to achieve their goal and make the Massachusetts Health Reform Act more perfect. Many observers consider that this act may help improve American health care insurance coverage, especially for poor and disabled people. In order to accomplish all tasks of the plan, a lot of details and possibilities of the state must be taken into consideration.
The legislation has to find out techniques and methods in order to realize this goal. First, health care organizations and groups of providers must work together in order to achieve health care improvement at lower prices. Second, the Commissioner of the Insurance authority division is supposed to decide the increase of health insurance taking into consideration new criteria. Third, integrated care organizations must be created by 2015. Fourth, accuracy and transparency of costs, payments, quality measures and clinical outcomes have to be provided in order to improve health care services to the public. Fifth, the improvement of payment methods is needed. It is also worth mentioning the importance of communication between the providers and patients. The legislation must support payment reforms and help them to move forward. New programs and initiatives are the main features that may lead to success. Thus, health care providers must work together with the state authorities to develop the strategy, which will help make transformation in the health insurance system and payment reforms.
Key Features of the Plan
The research reports that the Massachusetts state government act ensures universal coverage to all residence regardless of their incomes, residence of living, social status, and background. For example, interest in the Massachusetts health care reform capture a lot of state residents as well as other residents nationwide. Bigby (2011) reports that, health reform in Massachusetts was initiated by Gov. Patrick, who announced the total insurance coverage for all state residents and control of rising costs and payments. The public interest to this act remains high, because observers monitor its progress. They also maintain health insurance coverage for all residents and control payments and costs. It is remarkable that in 2006 then-Massachusetts governor Mitt Romney accomplished the plan that had no analogues in the history of any other state (Blum, 2011). Therefore, Massachusetts is the first state in the USA to cover all its citizens with health care insurance.
As far as its costs are concerned, this act cannot be a perfect model for the American nation. This reform has changed the method of payment and doctors` approach to patients. According to the legislation changes, all health care professionals have to provide health care services to all residents. The reform encourages health care providers to be flexible using various methods of health care services (Cohn, 2011). It is important to mobilize previous experience and provide new methods and techniques in order to maintain qualified services.
The Massachusetts Health Reform Act has certain key features that may be identified as follows: Medicaid, Commonwealth Care, Commonwealth Choice, individual mandate, and play-or-pay mandate. Medicaid rolls approximately 76,000 people including long-term unemployed workers, children in families that earn up to 300% of the federal poverty level and disabled working adults (Turner & Persico, 2009). The research asserts that the new law does not bring benefits to all Massachusetts residents. The available information reports that those, who were previously uninsured and did not have Medicaid, are not satisfied with the new law. About 50% of the recipients consider that the law has hurting them, and only 22% directly say that the law is supporting them. Moreover, only 14% are sure that the costs had gone down, about 50% are sure that the law has caused cost to increase.
The cost of Medicaid is one of the biggest problems for Massachusetts. The number of unemployed residents has increased since the recession period, thus, rising the demand for this program. It is worth mentioning that qualifying for Medicaid is much easier than in other U.S. states, though it is putting a huge pressure on Massachusetts financing. It is estimated that most of health care spending goes to Medicaid. Research asserts that it goes up from 21% in 2000 to 37% in 2011. The available information asserts that Medicaid grew by $2 billion in 2011 (Levenson, 2011). Medicaid has been the problem for health insurance and the state budget for 25 years. Other state programs are supposed to be cut because of its relentless growth.
Research asserts that beneficiaries, who are enrolled in Medicaid, i.e. people with low income and those with disabilities often complain that too often medical care they received is fragmented and has very poor health outcomes (Cohn, 2011). Therefore, a lot must be done in order to overcome these problems and improve Medicaid and complex health care needs of the patients. The federal government spends a lot of money for Medicaid support of the businesses and different companies. Due to this support, Massachusetts is able to provide health insurance coverage for all its citizens.
The Massachusetts Health Reform Act has created Commonwealth Careprogram, which supports about 177,000 residents receiving health insurance program. Through this program, people with incomes below 300% of FPL (Federal Poverty Level) are receiving health insurance. Commonwealth Care is one of the most recent programs that were provided as a key element of the Massachusetts Health Reform Act (Turner, 2009). Those who are not eligible for Medicaid are supposed to be covered by Commonwealth Care. This program provides health insurance mostly for those citizens, who have no health insurance at their work places, or for those, who do not work. It provides an access to the residents of Massachusetts, who make below 3005 of the FPL. The research asserts that Commonwealth Care requires higher co-pay for individuals, who are insured by this plan. Thus, $5 is charged for a visit to a primary care provider, and the same amount for a prescription. Each single person, therefore, would pay extra $10,400 per year. This is a great amount of money for those residents, who live just above the FPL.
Another key feature which provides the access to have health insurance due to the Massachusetts Health Reform Act is an individual mandate. It imposes fines on those, who do not receive a waiver. A play-to-pay mandate is also one of the health insurance coverage programs. It ensures employers with more than 11 workers to contribute minimum 33% of the cost of premiums and cover about 25% of their employees. Otherwise, they would have to pay a fine $295 per each worker. The research reports that 72% of Massachusetts employees are enrolled in health insurance. It is worth mentioning, therefore, that the national coverage is 59% (Long, 2008). Research asserts that all available health insurance programs in Massachusetts are directed to cover employees spending on their health care. Unfortunately, the Massachusetts Health Reform Act has many challenges that are of the utmost attention of the government and designers of this bill.
Challenges and Future Trends
Like any other programs, the Massachusetts Health Reform Act has many challenges supposed to be overcome in the future. The biggest problem is that Massachusetts has the high cost of health care services and insurance (Turner, 2009). Professionals argue that insurance coverage of all residents has led to the problems of those, who were not insured and paid the health care bills. Today, health insurance in Massachusetts costs 30% higher than in other American states. Thus, compulsory health insurance costs approximately $16, 897 for a family of four persons in Massachusetts, while in other states it costs around $ 12,700. State and health care officials are worrying about this fact and trying to implement the appropriate measures to improve this situation. Three main insurance plans, mentioned above, are regulating health insurance process in the state. Thus, there is no competition and very little consumer choice. The government regulations control most of the businesses and their health insurance plans.
According to this reform, regular citizens and private companies have lost the opportunity to be engaged as partners while creating health insurance plans. This research asserts that the Massachusetts health care system cannot be a model for other U.S. states, which have different health insurance coverage for their residents. The study informs that instead of lowering costs the health reform has become more expensive as it was expected (Long, 2008). According to the reform, for example, all prescribed drugs must be covered by the insurance plan. This increases costs for insurance that is usually challenging for small companies. Initially, managed healthcare was a great idea, but most insurance companies do not manage proper insurance to the patients. Many experts consider that most insurance companies just manage money in most cases (Long, 2008). Thousands of patients avoid visiting hospitals. Instead of this they prefer less expensive medical offices in their residential areas.
The information mentioned above proves that despite the Massachusetts Health Reform Act has provided a new approach to the health insurance system, it has many gaps that should be identified and fixed in the future. Some experts argue that the Massachusetts plan is an example of federalism, and it is necessary to create a competitive marketplace for alternative health insurance system that may provide uninsured residents to use hospital emergency rooms at taxpayer expense. The state authorities are working to develop the strategy in order to make helpful transformation in order to support and improve this plan. It is important to understand that more hospitals and doctors are supposed to be involved into the global payment system in order to give an access to treatment for poor residents. In order to achieve universal coverage for all residents, the authorities have to overcome all problems and complexities in order to achieve their goal and make the Massachusetts Health Reform Act more perfect.
The Massachusetts health care Reform Act has become an important issue of today`s discussion among government authorities, health care providers and consumers. In order to achieve universal health care insurance coverage and control of costs and payments. Today the bill is facing many challenges and problems that enable the legislation to implement the appropriate measures for its improvement. Congress is supposed to support new initiatives and provide regulation of health insurance in public and private sector, expansion of Medicaid and Commonwealth care. The Massachusetts health reform is still in progress now. State officials and health care professionals continue to advance this reform in cooperation with business community (Turner & Persico, 2009). The present Massachusetts governor Deval Patrick made a great contribution into implementation of all initiatives into reality. In present, this health reform plan is being developed and observers are cautious about the outcome. The residents hope for better results in the nearest future.
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