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Implementing Obamacare: States will feel more than a little pinch

Re “In implementing Obamacare, a lighter touch is better” (Editorial, May 12): If Massachusetts, the model upon which Obamacare is based, needs transition rules and grace periods to implement the health reform law, imagine what’s happening in states across the country. The changes needed to implement the law in Massachusetts pale in comparison to the massive changes, and resulting disruption, in every other state. Instead of a “lighter touch,” federal officials have taken a ham-handed, one-size-fits-all approach. It won’t work.

I support the premise of the law, or at least the law’s intent. I think it’s shameful that this country doesn’t provide everyone with a base level of coverage. I worked to implement the Commonwealth’s 2006 health reform law. And I think it’s wonderful that in our state most people have access to affordable, comprehensive health insurance.

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However, I’ve also worked in states across the country — red (Alabama, Tennessee, Kentucky), purple (Nevada), and blue (Connecticut, Delaware) — to help them implement Obamacare. And I know firsthand how complicated the law is, how overly prescriptive the regulations are, and how difficult, and disruptive, it will be in most states to change the way health insurance works in 2014.

What worked in Boston won’t work in Montgomery, Nashville, Frankfort, and Carson City, nor even in Hartford and Wilmington. Democratic senators, as you note, have reason to be among the anxious.

Bob Carey


The writer, former director of policy and development at the Massachusetts Health Connector Authority, is a health care consultant.

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