Today we celebrate the one-year anniversary of the enactment of the Patient Protection and Affordable Care Act, known to many by its nickname, ACA. This historic legislation, closely modeled after the health care reforms that Massachusetts enacted in 2006, will eventually provide an additional estimated 32 million Americans with access to comprehensive, affordable health insurance coverage. While most of the major reforms of the ACA do not go into effect until 2014, Massachusetts and its residents have already seen many benefits in this first year since the law’s passage.
Massachusetts already had many important protections in place for consumers with private health insurance; the ACA brought additional protections that became effective September 23, 2010, such as: prohibiting health insurers from having annual or lifetime limits on benefits and eliminating copayments for preventive services.
Similarly, ACA has brought additional benefits to residents of the Commonwealth such as:
- Eligible small employers now qualify for a tax credit;
- Businesses can take advantage of an Early Retiree Reinsurance program
- Seniors and disabled individuals on Medicare who fell into the Medicare Part D coverage gap or “donut hole” received a $250 credit to help with their prescription drug costs.
As a result of ACA, the Commonwealth has received more than $158 million in grant awards. The grants received to date include:
- $110 million over five years for “Money Follows the Person”, a program that helps move people out of institutional settings by providing needed community supports;
- $34.3 million to support a project with the other New England states to develop the systems needed to run Health Exchanges as a one-stop-shop vehicle through which people can purchase health insurance;
- $2.4 million for a program to train personal and home care aides;
- $1.9 million to support public health programs and expand access to care; and
- $1.6 million to provide coordinated services to pregnant and parenting teens.
The complete list of the ACA grants received by the Commonwealth so far is available at: www.mass.gov\nationalhealthreform.
As we look forward to the second year of national health care reform and beyond, Massachusetts and its residents can look forward to even more benefits as a result of the legislation. These benefits include:
- Additional federal funding for coverage that Massachusetts currently funds within the Medicaid and Commonwealth Care programs, including coverage for legally residing immigrants;
- Individuals with income up to 400% of the federal poverty level, or FPL (currently $88,200 for a family of four); will receive tax credits to purchase health insurance. Currently individuals with income up to 300% FPL ($66,000 for a family of four) receive subsidies under Massachusetts health reform;
- The Medicare Part D “donut hole” will be phased out — saving individual Medicare beneficiaries hundreds, even thousands of dollars per year; and
- Additional consumer protections including the elimination of the six-month waiting period currently in place for individuals with pre-existing conditions.
Many more grant and demonstration opportunities will provide funding for innovations, including reform efforts to change how we pay for care and the expansion of programs that serve the elderly and the disabled in the community. Additional grant opportunities will be available to support medical schools, hospitals and educational institutions, and to support health care workforce training.
While Congress and much of the country remain divided on the benefits of the ACA, we in Massachusetts have witnessed state reforms that resulted in near-universal coverage. Massachusetts led the way in tackling the problem of access to coverage first and the Patrick-Murray Administration is deeply committed to now working on lowering the costs of health care. We will do everything we can to take advantage of payment reform opportunities in ACA to help achieve this important goal.