Annual Report on the Massachusetts Health Care Market

Commonwealth of Massachusetts
Center for Health Information and Analysis, August 2013

In a continuing trend, the health coverage available through Massachusetts employers in 2011 cost more and had lower benefit value. Between 2009 and 2011 premiums rose by 9.7% to pay for benefits that decreased by 5%. Consistent with this trend, employees are paying increasingly more out-of-pocket for their health care. Deductibles have grown in Massachusetts by more than 40% between 2009 and 2011.

This dual trend – increasing premiums and decreasing benefit levels – was consistent across market sectors, but the effect was not the same for all sectors. The effect of increased premiums coupled with benefit declines was most pronounced in the small group market sector, where the benefit value started out lower and decreased faster (-7.5%) than in other market sectors. Although the small group market sector accounted for just 16% of the Massachusetts commercial insurance market, it included the greatest number of businesses. This sector is one of the most vulnerable to cost increases and has been the focus of policy interventions at both the state and federal levels.…

Many Health Insurers to Limit Choices of Doctors, Hospitals

By Anna Wilde Mathews
The Wall Street Journal, August 14, 2013

The new consumer marketplaces created by the federal health law… Many of the plans will include relatively few choices of doctors and hospitals.

Insurers are betting that consumers who buy plans on the exchanges will be willing to trade some choice and flexibility in order to get cheaper premiums. Smaller networks of providers generally translate to lower premiums.

A spokeswoman for the federal Department of Health and Human Services said that in the new marketplaces, “plans will compete side by side, and consumers can compare based on the factors that are important to them to find the plan that best fits their needs and budget.”…

Under Massachusetts health care reform, the largest sector of health insurance – employer-sponsored plans – continues to cost more while benefits decrease in value. Just in the two years from 2009 to 2011, the average increase in premiums along with the decrease in benefits resulted in a decline in value of 14.7 percent!

Nationally, the same process is underway, and it is fully predictable that it will increase under Obamacare – a model of reform very similar to that in Massachusetts. We will all be paying more to get less.

Worse yet, we will have even fewer choices of our physicians and hospitals as insurers shift more to narrow-network plans.

Don’t worry though. HHS assures us that with competitive plans we will be able to “to find the plan that best fits (our) needs and budget.” We will have our choice of a selection of plans with higher premiums, lower benefits, and less choice of our health care providers.

Of course we could have had, and still can have, an improved Medicare for everyone that would replace premiums with equitable taxes, provide comprehensive benefits, and give us free choice of our health care professionals and institutions. Too bad that we believe our politicians when they tell us that single payer isn’t politically feasible. Come to think of it, whose politics is that anyway?