Massachusetts Gov. Deval Patrick shamelessly boasted about his state's mandated exchange-based health insurance program at the Association of Health Care Journalists conference this month in Boston.
Six years into the program, some 98 percent of Massachusetts residents have health insurance, more than 90 percent have a primary care doctor that four of five have seen in the past year, 150,000 have quit smoking, emergency room visits are down, he said, and health screenings have saved lives, including a 30 percent drop in cervical cancer alone.
“For us, health is a public good,” Patrick said.
Spurred by the instantly likable Patrick, I was awed and inspired by the successful statistics. But journalistic objectivity — or healthy temperance — returned, when I was reminded by friends in Boston, and subsequent panelists at the conference, that the way stats are presented can be misleading.
Ninety-five percent of Massachusetts residents already had health care before Romneycare, my friends told me. And though rates for individuals have come down, rates for small businesses have shot up, they said, along with costs associated with additional mandated benefits.
After spending tens of millions on advertising, including on the Jumbotron at Red Sox and Celtics games, The Massachusetts' exchange covers only 4,600 lives in the small business market — compared with projections of 300,000, said Josh Archambault of the Boston-based Pioneer Institute. And while more companies, some 76 percent, are offering insurance, fewer employees are taking it — 50 percent in 2011, down from 67 percent in 2001, he said.
Over the last four years, the Commonwealth has seen an 8 percent increase in the number of companies moving to self-insured plans, where they, though assuming more risk, can avoid many government mandates, Archambault said. Some 55 percent now are self-insured, he said. Meanwhile, The New York Times recently reported healthier companies with as few as 10 to 20 employees are considering the move, with the key mandates for federal health care reform looming Jan. 1.
Columbia Journalism Review blogger Trudy Lieberman urged colleagues to report on the National Federation of Independent Businesses' protest of Obamacare's tax on insurance companies. NFIB fears the tax — which is expected to raise some $87 billion over 10 years to pay for the subsidies for the uninsured — will be passed onto small businesses in the form of higher premiums for their workers.
Jonathan Gruber, an economic professor at the Massachusetts Institute of Technology, and other presenters wholeheartedly support the Massachusetts and federal reforms. If built correctly, exchanges can pay for themselves, said Gruber, adding that states, like Florida (and Oklahoma), that choose not to expand Medicaid are doing a “massive disservice” to those who live below the poverty line and will have no other recourse for accessing health care, or some 1.3 million Floridians. Gruber believes states ultimately will choose to take the federal money because it's a “huge stimulus.”