Right, wrong or indifferent the citizens of Massachusetts are mandated to have health insurance by the 2006 Massachusetts Health Care Reform Act. The goal, as stated by the MA Department of Revenue is to "ensure that virtually all Massachusetts residents have affordable, comprehensive health insurance...". This is old news, right? Well, the answer is yes and no. The Act may have just had its 5 year anniversary, however the political figure and potential republican presidential nominee, Mitt Romney (who signed the Act into law), is bringing the topic back into the news forefront and he's not hollering it's praises from the rooftops.
Just how much does the average person know about the Act, how have they been impacted, and has MA healthcare reform been a success or a failure?
Whether the reform has been a success or a failure is largely subjective. The goal as stated is somewhat vague. Facts show that more than 98% of MA residents now have insurance and this includes 99.8% of all children. In fact MA has the lowest rate of uninsured people in the United States. That sounds a lot like success. However, we must note that before the reform took effect, 94% of MA residents already carried health insurance.
Another factor of the goal states "affordable, comprehensive health insurance." According to the independent group Massachusetts Taxpayer Foundation the program has been relatively affordable for the state; accounting for a net increase in spending of just 1% in 2010. Again, we must frame that 1% in reference to the fact that it represents approximately $1.8 billion. Note that in addition, the state receives federal aide for the program.
If the goal is referring to affordable for the private sector, the rate of private spending per insured member has been increasing double digits. For example, as reported by ABC News, the median health insurance premium for a policy holder in MA was $442 in 2009, which was a 21% increase from 2005 median premiums. Moreover, BCBS published a survey in April of 2011 estimating per capita health care spending in MA to nearly double by 2020. Also interesting and perhaps significant, bankruptcy filings due to medical costs increased by more than 1/3 from 2007 to 2009, (according to The American Journal of Medicine).
As to the "comprehensive health insurance," a BCBS survey stated that 88% of doctor's feel that the Act improved or did not affect the quality of their care. Massachusetts has always had exemplary medical facilities and therefore, it would seem that this remains true.
Whether you feel the reform is a success or a failure is your call, yet two out of three adults in the state support the law.
How has the average MA resident been affected? Remember, before the act went into play, 94% of us were already insured. Though I can not speak for all of Massachusetts, for me the direct impact has been making sure I file the 1099HC so I avoid penalty and in my tax practice, making sure I seek out those forms from my clients. Besides paperwork, I have noticed a trend of rapidly rising co-pays and premium costs that may or may not be related to the reform.
THE FACTS:
What does it mean if you do not have health insurance? Self insurance is not an option in MA and your assertion of infringement on your civil liberties is not a listed exemption. Exemptions from mandatory coverage must be applied through the Connector's office and a Certificate of Exemption indicated on Schedule HC. For more information visit: https://www.mahealthconnector.org/portal/site/connector/menuitem.a6bd9ea72595da2ea87b5f57c6398041/?fiShown=default
Exemptions:
• Affordability is determined and published in an annual schedule that can be found in the instructions to MA Form HC at http://www.mass.gov/Ador/docs/dor/health%20care/2011/sch_HC_wksht_tables.pdf
• Religious belief must be asserted by filing a sworn affidavit with your personal tax return.
• Hardship can be claimed even if the worksheets for Schedule HC show that the taxpayer could have afforded insurance. Hardship appeals are requested on the income tax return by completion of MA Schedule HC-A.
If you do not fall under one of these exemptions, a penalty will be assessed for EACH of the months you did not meet the requirement of creditable coverage. The Commissioner publishes annually a penalty schedule. The 2011 schedule can be found at the following link:
http://www.mass.gov/?pageID=dorterminal&L=7&L0=Home&L1=Businesses&L2=Help+%26+Resources&L3=Legal+Library&L4=Technical+Information+Releases&L5=TIRs+-+By+Year(s)&L6=2010+Releases&sid=Ador&b=terminalcontent&f=dor_rul_reg_tir_tir_10_25&csid=Ador
Note that penalties under the mandatory health care requirements are due as of the ORIGINAL due date of the return without regard to extension and that interest and penalties accrue in the same manner as applied to unpaid taxes.
CORPORATE PENALTIES - Carriers, employers or other sponsors of health plans are required to provide Form MA 1099-HC annually before January 31. Any who fail to provide the written statements to covered individuals will be assessed a penalty of $50 per individual up to $50,000 per year.
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