The Massachusetts Model Of Healthcare Reform

Individuals are required to purchase their own insurance if their income is above the guidelines.

There is a connection between socio-economics and health.79 Therefore, it’s expected when a states decided to expand Medicaid for more low-income residents, and then that population of people tend to be sicker than the rest of the population (Gershon & Sullivan, 2014). These reasons for expanding Medicaid will transfer those individual’s off the exchange policy into Medicaid, especially those within 100%-133% FPL range. Medicaid expansion could cause the exchange risk pools to become healthier, which means a healthier-risk pool that may be a financial boom for insurance companies that have participated in the exchange. Insurers that participate in the exchange are subject under law, to loss of medical ratio’s; which prevents them from retaining more than a certain level of profit (Gershon & Sullivan, 2014). In cost savings, with a healthier- risk pool possibly can be passed down for other consumer’s to use.

Conklin, T. P. (2002, Fall). Health Care in the United States: An Evolving System. Michigan Family Review, 07(), 5-17. Retrieved from

In 1954, Congress passed legislation allowing employers to provide health insurance benefits to employees on a tax-free basis (Sih and Singh 99). This legal provision marked the beginning of the rapidly expanding health care costs still apparent today due to the major incentives provided by the government to obtain employer-based health coverage. The overwhelming popularity of employer-based health insurance has led to a serious market inefficiency resulting from the system of third-party payment. As individuals rely on their insurance companies to pay for their medical expenses, this provides

The Affordable Care Act was into law March 2010. The law has planned to make wide-range of changes to healthcare in the United States. The Affordable Care Act efforts to offer universal right to use to healthcare for Americans, control the rising costs of healthcare, adjust the private insurance industry complete things like state-based private exchanges and online marketplace that brings together state-approved insurance plans from multiple companies so consumers can shop for individual insurance plans, improve the quality of healthcare and make healthcare choices more consumer friendly and easier to understand (Medical Mutual,2017). Healthcare reform involves nearly all Americans from old or young,

Throughout the early 1980’s and 1990’s the Federal Medicaid program was challenged by rapidly rising Medicaid program costs and an increasing number of uninsured population. One of the primary reasons for the overall increase in healthcare costs is the

Texas has the largest uninsured population with an estimated 6.2 million uninsured citizens within its stateliness, approximately a quarter of the statewide population (Rapoport, 2012). In 2012, then governor, Rick Perry decided that Texas would not expand Medicaid under the Affordable Care Act (ACA). This decision led to much debate over whether or not Perry made the right decision to leave upwards of a million Texans, who did not receive insurance subsidies and did not qualify for Medicaid, uninsured. These Texans fell under what many politicians refer to as the “coverage gap.” Texas decided not to expand Medicaid under the Affordable Care Act because of the effects it would have on hospitals, financial reasons, and increased number of

Since the implementation of the Affordable Care Act (ACA) in 2010, there has been a continuous debate about the effects it will have on the United States economy. Many people argue that expanding insurance coverage for all people will create crippling cost burdens for the economy and taxpayers. While others believe that the ACA will in fact give the economy a much-needed boost. In 2006 as a measure to improve overall healthcare, the state of Massachusetts implemented the Health Care Insurance Reform Act. This paper looks at the positive and negative effects of the Massachusetts Health Care Insurance Reform Act (MHRA). Using a literature review of public health studies ranging from 2009-2012, I argue that there are both positive and negative effects of the Massachusetts Health Care Insurance Reform. While the Massachusetts Reform increased health insurance coverage for all citizens and decreased the number of uninsured citizens accessing emergency rooms, it also did very little to decrease already existing racial, ethnic, and socioeconomic disparities among minorities and whites in the state of Massachusetts. Understanding the Massachusetts Health Care Insurance Reform Act may help in the goal of trying to achieve near-universal healthcare. This paper provides an understanding of the missing pieces in the Massachusetts Health Care Insurance Reform Act and constitutes a starting place from which to understand the Affordable Care Act.

Another issue was the fact the large employers that received self-insurance were progressively giving up health insurance as an employee benefit. They also mandated that only full-time employees would be eligible for the insurance benefit. These issues among others are why advocacy groups and state legislators felt very strongly that some kind of health insurance reform was necessary.

In Massachusetts, the Massachusetts Health Care Reform Act had a considerable impact on hospitals and the health care system. Most community health centers were benefiting from coverage expansions and safety net hospitals were struggling financially due to the fact that the state put more funding towards insurance subsidies to expand coverage. Academic medical centers (AMC) were able to

According to Ingols and Brem (as cited in Swayne, Duncan, and Ginter, 2006), Massachusetts is known across the world for computer technology, education, and health care. In the words of the authors, Massachusetts' "health care expenditures per capita were between 27 and 29 percent higher than the national average from 1990 to 2000." At the time, there was a general consensus that Boston's health care was relatively expensive as a result of the region's cutting edge and high quality services (Ingols and Brem, 2006). During the 1990s, a number of healthcare insurance plans at the national level chose to merge in an attempt to further enhance their ability to compete effectively. This trend according to Ingols and Brem (as cited in Swayne, Duncan, and Ginter, 2006) was also replicated in Massachusetts where the eventual formation of three large competitors had far-reaching consequences. One consequence of the increasing power of these three formations in the marketplace was reduced payments.

Businesses that have employees that are over 50 in number should offer their employees health insurance otherwise; they are taxed a penalty. Under such a circumstance, the government subsidizes full time employees’ healthcare via deductions of taxes or other eligible means, which is chiefly known as an

With this definition, it’s easy to see that health care reform impacts the economics of health care in many ways. The most significant change is the decrease in health care disparities between those with private insurance and those with limited or no coverage. The ACA brings much-needed resources to those underserved groups. Even with the Medicare/Medicaid expansion and the addition of Marketplace insurance, disparities still exist. In my unit, patients with private health care can often not schedule their procedures immediately, while those with Molina and Care Source must try conservative therapy first. Overall, levels of disparity are improving, but the two health care delivery systems are not yet equal. Lawmakers should consider universal health care to provide equal access to health care for all citizens. Other examples of how health care reform affects health care economics include focusing on preventative care, moving from the fee-for-service model to one in which the provider is paid based on quality, efficiency, and value of care given, developing accountable care organizations in which health care networks and physicians join to deliver improved care at a lower cost, and incorporating a universal EHR which decreases costs by decreasing errors and decreasing the duplication of services (Ballotpedia, n.d.). Next year, Ohioans may feel

Reducing barriers in the State healthcare system is something that needs to be acknowledged in our society. The healthcare system is a complex organization that regulates the payment of services rendered to be, if and when they perceive suitable. The amount of people who struggle with unpaid medical bills is astonishing, although the amount of people who cannot afford insurance or can’t afford to pay high deductibles or copays is even more alarming. More often than not we equate success with a decent paying job that offers healthcare insurance. There is a large population that is uninsured or underinsured, and our society deems this person as a failure in some aspect, therefore unworthy of assistance. Luckily, each state offers

First, the individual mandate requires individuals to purchase health insurance or pay a penalty tax. There are exemptions but these do not apply to our clients or their employees, as the facts have been presented. The practical effect of this for our clients, is that each owner and employee must have health insurance. This leaves each individual with two options, purchases his or her own insurance or the company buys a health insurance plan for the employees. Going without health insurance is hardly an option given the harsh penalties imposed under the ACA. At this point in time, the penalty is the greater of (1) $695 per individual and $347.50 per child (up to a maximum of $2,085 per family) or (2) 2.5 percent of the family’s income.