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Attacks on Romneycare come even as costs turn the corner

JUST AS the Massachusetts system of delivering health care is under attack from Republicans across the country, along comes more evidence of its success - this time, in helping to create more affordable options for individuals and small businesses.

The cost savings are important because both “Romneycare’’ and its famous offspring, President Obama’s health care overhaul, were branded mainly as ways to decrease the number of uninsured people, partly through the much-demonized requirement that individuals who can afford insurance must buy it, and the mandate on some employers to provide insurance, as well. But those mandates also served to bring together larger groups of customers, giving insurers greater incentive to provide competitive rates.


The Massachusetts Health Connector - a key component of Romneycare, copied in “Obamacare’’ - has dramatically expanded and improved its offering for small businesses through its Business Express program. Launched in 2010 with a limited number of insurance carriers, Business Express has now added Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, Tufts Health Plan, and Fallon Community Health Plan, dramatically increasing the choices available for companies with 50 or fewer employees.

Upon filling out an application on the Connector’s website, a process that takes about 15 minutes, business owners can receive quotes from insurers within about a minute. The website allows an apples-to-apples comparison of the available health insurance options, including design details and premiums. Glen Shor, executive director of the Connector, notes that even before the program’s expansion, one small-business CEO wrote to say that his company had used Business Express to find a plan that saved it $9,300 over what it otherwise would have paid for comparable coverage.

The Connector has also added a wellness component to its Business Express plans, which can mean a rebate of 15 percent off the employer’s share of health care premiums. To be eligible, businesses must have fewer than 25 employees, contribute at least half of their employees’ premiums, and have an average salary, exclusive of owners’ and family members’ pay, of less than $50,000. To earn the rebate, eligible firms must promote a healthier workplace by doing things like offering smoking-cessation programs, helping employees incorporate more physical activity into their day, promoting better workplace nutrition, and attending to ergonomic issues; the company’s employees must get physical exams.


Still more needs to be done to drive down the costs of health insurance, but recent evidence shows that a comprehensive approach to managing coverage and competition among insurers can bear substantial fruit. More good news came recently from the Group Insurance Commission, which provides health plans for state workers and, thanks to last year’s municipal-reform bill, an increasing number of city and town employees. The GIC just announced that its average premium increase for the next fiscal year will be only 1.4 percent, the lowest since 1999. Taxpayers will be the main beneficiary.

Both the GIC’s success in restraining premium increases and the Connector’s new small business offerings are impressive developments for which credit should go to providers, for reining in their own costs and reimbursements; to insurers; and to both government agencies. Kudos, too, to the authors of Romneycare, who have helped pave the way to a more economical health system.