1. Jon Kingsdale, Ph.D. Executive Director May 15, 2008 Progress Report on Massachusetts Healthcare Reform

2. 2 Progress Report 1. Reasonably good progress to date 340,000 newly covered Popular and political support Acceptable costs per enrollee 2. Not the end, but the start of reform 3 years to enact, 3 more to implement Healthcare Reform II 3. Challenges Maintain support Find the money Improve value

3. 3 340,000 Newly Insured (as of 1/1/08) Programs phased in: MassHealth expansion (July 06) Commonwealth Care – free (Nov. 06) Commonwealth Care – contributory (Feb. 07) Non-group reform (July 07) Individual mandate (July 07 – 08) Free care eligibility restricted (Oct 07 – April 08)

4. 4 340,000 Newly Insured (as of 1/1/08)

5. 5 Commonwealth Care Spending (millions)

6. 6 Maintain/Enhance Employer Support 55 percent of MA employers agree with requirement to offer or pay fair share contribution (41 percent oppose) Employers offering ESI in 2007: MA: 72 percent US: 60 percent Growth of ESI in MA, 12 months ending Jan. 08: 85,000 newly covered lives

7. 7 Support for MA Health Reform Law

8. 8 Reforming the Non-Group Market, July 2007 Plan choices for typical uninsured 37-year old Pre-reformPost-reform Monthly Premium $335$184 Rx coverageNone$100 deductible Deductible$5,000$2,000

9. 9 70 percent of net growth in non-group insurance in 2007 through Commonwealth Choice

10. 10 Healthcare Reform Success: Decreasing free care A recent report by the Massachusetts Hospital Association shows that enrollment in Commonwealth Care and MassHealth has increased by 28% since October 2004, while the number of hospital low-income uncompensated care accounts has decreased by 28% over the same time period Source: MHA

11. 11 Challenges Ahead 1.Taxpayer acceptance 2.Primary care capacity 3.Crowd-out 4.Cost of care