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The $115 million in cuts to the state's landmark health care program made by its overseers at the Connector Authority are painful but unavoidable. A victim of the poor economy, and ironically of its own success in helping victims of that economy, the program's difficulties testify to the problems inherent in our nation's health care system, problems that Washington must address on a larger scale.
The 12 percent cut in Commonwealth Care is a product of budget cuts reflecting the economic crisis and increased enrollment in the program, primarily because residents laid off from their jobs and deprived of their employer-based health insurance joined the state program in droves. The largest share of the $115 million will come from slowing the pace of enrollment, which is counter to the initial goal of the effort. However, the Connector Authority will no longer automatically enroll an estimated 18,000 poor residents who qualify for full subsidies but neglect to designate a plan, creating delays that will slow enrollment. Roughly $10 million will be saved by eliminating dental coverage for 92,000 poor residents. Governor Patrick may try to protect insurance for 28,000 legal immigrants removed by the Legislature, but if he does, money will have to be cut from somewhere else.
Nearly 98 percent of Massachusetts residents are covered by health insurance, and the state's poorest residents, many of them children, have subsidized coverage courtesy of Commonwealth Care. But while the program is referred to as health care reform, it is more accurately an imaginative effort to circumvent the problems with our nation's privately administered, employer-based health care system that cannot be reformed at the state level. That Commonwealth Care is springing leaks is not surprising.
State Treasurer Timothy Cahill attacked Governor Patrick and the Legislature on a variety of fronts Tuesday, and while he appears to be setting the stage for a bid for governor in 2010, his statements on the state health care initiative had some merit, even if politically motivated. Mr. Cahill is correct that in the rush to get Commonwealth Care up and running in 2006, enthusiastic state officials did not ask tough questions about the program's costs, which have increased by about $88 million annually since it was implemented according to the Massachusetts Taxpayers Foundation. In demanding major cuts to the program, however, the treasurer was unfairly dismissive of universal health care, because the state's attempt at it is hampered by systemic flaws that cannot be reformed away at the Boston level.
There should be no connection between someone's employment status and their health care status, yet Commonwealth Care is buckling under the strain of new enrollees who lost their health care coverage along with their salaries. The health care industry, with its mammoth bureaucracy and excessive management salaries, is an oppressive burden on workers, employers and state officials.
Creation in Washington of a meaningful "public option" national health care plan undiluted by timid Red State Democrats and Republicans pocketed by the health care industry will at least make a dent in our systemic problem and take some of the pressure off Commonwealth Care, which is being knocked about by forces outside its control. Massachusetts can't reform health care on its own.
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