Hundreds of healthcare journalists will be attending the Association of Health Care Journalists’ (AHCJ)  conference in Boston this week to hear from many speakers with  rose-colored ideas about both our Romneycare law and a brand new state  cost-control law. Yet all is not well in the Commonwealth. State  officials now predict “extreme premium increases” for many small  businesses under Obamacare.
In a letter  to federal regulators the day after Christmas 2012, a perfect day to  bury news, Massachusetts officials floated the idea of obtaining a  waiver from the Affordable Care Act (ACA) out of fear of the premium  spikes. Yet, recently finalized federal regulations slammed the door on  that flexibility. Many small companies justifiably feel sick over the  decision.
 
Now the future looks even bleaker for small business. Not only will  their highest-in-the-nation premiums go up because of these new  regulations, but they will be paying on average $8,000 per family, per  plan more in taxes over the next ten years. That translates into employers and consumers in Massachusetts paying $213 million in 2014 and $3 billion more over the next decade.
Conference speakers will be sure to mention that the Connector was  created to help small companies obtain competitively priced insurance,  and other states will experience this benefit in the exchanges required  under the federal law. Only one problem, the rhetoric doesn’t match  reality in Massachusetts.
At the end of 2012, after spending tens of millions on advertising,  the Connector covers less than 1 percent of the small business market  and premiums are similar to those outside the exchange.
Finally, those in attendance will hear about a promising law  passed in July that will save the Commonwealth $200 billion over 15  years. Yet its approaches are rehashed old ideas. State government gets a  steroid shot of market oversight and permission to write regulations  freely. The law is heavy with groups of “experts,” requiring 278+ new  appointees, with some instructed to “rationally distribute health care  resources.” Is this the future of Obamacare?
Requesting a waiver from the ACA implies that Massachusetts deserves  to be treated differently. What about the dozens of states nationally  where premiums will spike anywhere from 30 to more than 100 percent,  especially for young adults?
Massachusetts has embarked on a seven-year health care experiment. It  has worked on some fronts and not on others. To argue that we are  special because we are leading the way on cost containment is premature  and begs the question of whether the ACA’s “one-size-fits-all” approach  is misguided to begin with. Let’s hope visiting reporters see the clear  picture.
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