1. Key Elements of Mass. HealthCare Reform Jon Kingsdale Bipartisan Congressional Health Policy Conference January 13, 2007

2. 2 Programmatic Elements Subsidized premiums (Commonwealth Care) Individual mandate Incentives for employer participation (>10) -S. 125 plans -Fair & Reasonable contribution Market reform (Commonwealth Choice) Enhanced Medicaid payments

3. 3 A Relatively Small Problem MA Population6.2 million Insured5.8 million Uninsured372,000 300% of FPL140,000 >300% of FPL160,000 Other 70,000

4. 4 Political Recipe for Reform Lots of money already in the system Well organized, funded & respected advocacy Bi-partisan commitment to health care reform Provider and insurer support for reform $385 mm federal carrot/stick Business acquiescence (culture of reform)

5. HCR: 5 years in the making 2003 Governor,BCBSMA, & ACT commit 11/04 Roadmap to Coverage Sen. Pres. commits 2/05 1-year extension of federal waiver 3-6/05 Governors Plan Sen. Pres bill Governors bills 11/05 Speakers bill 4/06 Enactment 7/1/06 Medicaid expansion 1/1/07 C-Care implemented 7/1/07 Individual mandate Employer assessment Non-discrimination C-Choice 10/1/07 UCP re-write 1/1/08 Real mandate in effect

6. Progress to Date Commonwealth Care for adults < 100% FPL October 1, 2006 start date Target population of ~60,000 50,000 individuals confirmed eligible 40,000 enrolled in health plans Commonwealth Care for adults 100% to 300% FPL January 1, 2007 start date Target population of ~80,000

7. Market Reform Create credible, non-group risk pool Merge small- & non-group rating Expand product options Create a new market for choice (Commonwealth Choice)

8. 8 Non-offered Individuals Small Businesses Sole Proprietors Non-working Individuals Blue Cross Blue Shield Fallon Harvard Pilgrim Commonwealth Connector Commonwealth Choice Health New England MMCOs Tufts NHP

9. Commonwealth Choices Value Proposition Individual choice Administrative simplicity Pre-tax premium payment Portability of coverage

10. Commonwealth Choices Value Proposition Sales to date = 0