AUG. 2, 2016 • BY JON HURST
As is often the case, the recently concluded formal session of the Legislature featured some wins—mostly in the defeat of costly employer measures—but some losses, primarily the continuation of existing discriminatory policies, which either result in lower sales, or higher costs for local sellers.
One important win was the passage of a measure to keep the state’s innovative Small Business Health Insurance Cooperatives operating and serving employers of 50 and under. RAM operates one of the existing three co-ops in the state, and thanks the Legislature--in particular the House of Representatives--for recognizing the costly, discriminatory and unfair application of health insurance rates under federal ACA rules. In the Economic Development bill passed Sunday, an important section sponsored by Representative Kate Hogan (D-Stow) allows for new financial incentives to use wellness and provider transparency tools through small business cooperatives. In reaction to double digit premium increases for small employers following the passage of “RomneyCare,” the Legislature in 2010 authorized group purchasing through non-profit cooperatives with upfront premium discounts. Yet, those savings are evaporating under preemptive ACA requirements on state rate setting. The ACA required phase out of state rating factors, means no upfront premium flexibility remains to award employees for using wellness programs, or to shop around for the low cost, high quality healthcare providers—common practices for large employers. The new state legislation moves upfront premium incentives to the end of the insurance contract period in the form of rebates, which remains legal under federal rules. The section also encourages the Baker Administration to seek an Innovation Waiver from the federal government under the ACA to seek more flexibility and fairness for Massachusetts small businesses and their employees. Without rate flexibility and consumer financial incentives, small business health insurance premiums are more accurately labeled healthcare taxes.