Massachusetts Health Stats

Health Connector Authority "Obamacare" Exchange Is Irrelevant in Massaschusetts

It's hard to follow all the numbers the Massachusetts Health Connector Authority is broadcasting this month but they really do not matter because they represent such a small part of the Massachusetts total that they do not even show up on a representative bar graph (see image below).

 

The important numbers relative to health insurance in Massachusetts are as follows:

• There are about 6,500,000 Massachusetts residents. Around 5,000,000 (77%) of us get our health insurance through current or former employment and could care less about the Massachusetts Health Connector
• Around 100,000 of us (1%-2%; see very top of each bar) get our health insurance ourselves on our own paying full price; between 2007 and 2013, a small number of this already small number used the Massachusetts Health Connector as an insurance broker; that was hard to do in 2014 because the Health Connector web site worked poorly
• Around 200,000 of us (3%; in red oval¹) never get or only occasionally get health insurance or Medicaid (called MassHealth in Massachusetts); we use the Massachusetts free care pool (name was called to the Health Safety Net in 2006), which is not insurance and which is funded by higher insurance premiums paid by the 5,100,000 people mentioned directly above; through the free care pool Massachusetts resident can go to one of Massachusetts' over 40 community health centers as well as to most Massachusetts hospitals; many of the people in the free care pool have trouble understanding all the crazy rules put out the the Massachusetts Health Connector Authority or Massachusetts Medicaid bureaucracy and prefer to keep their lives simple; most of them would qualify for a Connector Authority program or for Medicaid if they had made out the paperwork
• Around 1,000,000 Massachusetts residents (18%) qualify for and have signed up for Medicaid, which is also not insurance; those on Medicaid never have previously been involved with the Health Connector and it is unclear if they have to use it now (if so, they are certainly not flocking to it)
• Finally -- and this is the Health Connector Authority's only reason for existence -- about 200,000 (3%) Massachusetts residents used the free care pool before 2007 and were switched to RomneyCare (often without their knowledge) between 2007 and 2013; RomneyCare is insurance; RomneyCare provided most of the 200,000 mostly "free" insurance paid for by the Massachusetts free care pool (that is, paid for by the 5,100,000 noted above) and by Medicaid. (NOTE: RomneyCare is no longer offered and has been replaced by ConnectorCare, which I call Grubercare after its "architect.")

When those in this last small group in this list (the illustration breaks the group even finer, so fine that the various subsegments almost don't register visually) tried to renew their RomneyCare insurance a year ago, the new Health Connector website didn't work well so many of them were given Medicaid temporarily. Some of them were going to be put on Medicaid even if the web site had worked because of Obamacare. Because Medicaid is not insurance, many of them made other arrangements during 2014. This is driving the Health Connector Authority crazy.

¹An interesting aspect of the Massachusetts insurance-buyer-funded free care pool -- represented by the red oval -- is the fact that it went negative in 2014. That is, in theory Massachusetts had more people insured than it had people (as explained here). That's why the red oval in 2014 is below the bottom axis.

Why Is No One Signing Up for Grubercare in Massachusetts?

The Boston Globe, Associated Press -- and reportedly members of the Massachusetts Association of Health Insurance Plans -- is all atwitter the week of December 14 over the fact that no one allegedly is actually signing up for and paying for Grubercare¹ in Massachusetts during the Commonwealth's ongoing second try at bringing Obamacare to Massachusetts (after the failed first attempt in late 2013/early 2014).

All the hand wringing is a little nutty. Not to worry. Believe me, Jonathan Gruber and the rest of the Massachusetts Health Connector board and the whole Massachusetts state government is expert at giving away free stuff. And for most of us in Massachusetts the whole discussion is totally irrelevant. Here's how we in Massachusetts break out.

More Massachusetts Health-Care-for-All Deception about the Massachusetts Taxpayer's Bite for Healthcare Welfare

The head of Massachusetts' group of the far left wing wing national Health Care for All lobby is on a roll this week¹ in explaining the group's deceit concerning health care issues in Massachusetts. Quoted in the Boston Globe (may be firewalled; also check boston.com) concerning a Massachusetts State Auditor's report on Massachusetts Medicaid financial indiscretions, Amy Slemmer said

“This is a very minuscule amount of the overall MassHealth budget, under a tenth of one percent. We feel confident that the accounting issues have been fixed. Most of the insurance bills in question would have been paid anyway out of a different pool of money known as the Health Care Safety Net, which is an account largely funded through a surcharge on hospital and health insurers."

What's wrong with this quote?

Massachusetts Governor Baker Reportedly Considering Reappointing Gruber to Massachusetts Health Connector Authority

Massachusetts Governor Baker soon gets to show us how much he represents the real people of Massachusetts and the United States. Or, as I believed (and therefore blanked the Massachusetts governor's race last month), he's just another elitist goo goo in the Christian-Herter/Frank-Sargent/William-Weld/just-off-the-Mayflower Massachusetts-Republican crowd that ruined Massachusetts in the 20th century. Unbelievably, the new Massachusetts Republican governor is reportedly considering reappointing Jonathan Gruber to the Massachusetts Health Connector Authority as the governor's economist designee. 

It is unclear if Gruber has a specific term expiring on such and such a date or if he serves at the pleasure of the sitting governor. It is clear that Gruber holds a seat designated specifically for an economist. If the term is fixed, Governor Baker should push Gruber out the way Governor Romney pushed out the Congressional-Committee-staller William Bulger from the presidency of the University of Massachusetts.

Go Figure: Democratic Congressman Lynch of Massachusetts Did Best Job of Grilling Gruber

As Congressman Cummings said in his opening remarks, putting MIT's lying economics professor Jonathan Gruber "on the stand" in the House hearing room was simple political theater.

Gruber did worse than I expected in defending himself but the House Oversight Committee Republicans did an embarrassingly terrible job of questioning Gruber. Democrat Congressman Lynch of South Boston did the best questioning job, forgetting the easy jabs and instead narrowing in on the Patient Protection and Affordable Care Act's 40% Cadillac tax that will hurt¹ union contracts Lynch negotiated before becoming a Congressman (as well as the policies of the other 50% of you out there that get your healthcare insurance from an employer and retirees with good Medicare supplements from former employers and unions).

More Far-Left-Wing "Massachusetts Sucks for Seniors" Crap from Organizations Sucking Medicare Dry

One of the biggest drains on the Medicare trust funds are funds for shady home health care services. Maybe related, maybe not there is a home care group that spends tens of thousands of dollars annually lobbying the Massachusetts legislature with a strange stew of "our clients (seniors) are stupid" mixed with a mid-1930s-sounding Socialism/Communism manifesto. Luckily its lobbyist -- who publishes tripe regularly in a left-wing blog called Over 50 Advocates¹ -- does not speak for we seniors. If he or she did, his or her proposals -- which basically say that we seniors all should be put on Medicaid and/or be farmed out in our older years to his or her government-funded clients -- might cause concern.

So you can pretty much dismiss this group's nonsense except for its recent unsourced reference to a “recent report” about economic insecurity among Massachusetts citizens over 65.

The Guys That Brought You the Subprime Mortgage Disaster Now Analysing Massachusetts Healthcare Reform

The Boston College Center to Study and Fool Old People¹ -- or some such odd name only a Jesuit would love -- has put out a silly report about how RomneyCare helped the self-employed in Massachusetts and incentived thousands of us Massachusetts sixty somethings at the time to run out and start our own business. I was a self-employed person in Massachusetts at the time RomneyCare passed, and believe me the now effectively repealed RomneyCare was the worst thing a self-employed person ever saw. 

This flawed Boston College research appears to be political-agenda-driven deception. It says:

“The key components of the (RomneyCare) reform were a state health insurance exchange, an individual mandate, an employer mandate and expansions to Medicaid and Children's Health Insurance Program.”

Wrong!

After 30 Years, 100% of Massachusetts Residents' Still Get Covered Health Care

There is all kind of left- and right-wing propaganda floating around in late 2014 that claims to capture the percentage of "uninsured Americans¹" before and after the 2010 passage of the Patient Protection and Affordable Care Act (PPACA, better known as Obamacare). Much of the coverage also compares the numbers to the poor to failed initial 2013 attempt by the Federal and some state governments to become insurance brokers (known as the "Obamacare exchanges"). To the extent these statistics include Massachusetts, the national numbers are quite misleading.

1. Massachusetts exchange basically never worked in 2013 so any comparision with last year is ludicrous
2. Massachusetts is entering the 30th year of "guaranteed coverage²" of most health care costs for 100% of its citizens, the 30th year since the 1985 passage in Massachusetts of the "free care" tax on our health-care insurance policies and hospital stays, a tax that heavily supported community health centers and their pharmacies and also compensated acute care hospitals for Massachusetts always relatively low percentage of uncompensated care.

The late 2014 news coverage of the Massachusetts "uninsured" numbers are especially strange because these numbers will actually go down in 2015 by definition.

Massachusetts Senators Markey, Warren Protest Obama's Crackdown on Massachusetts Medicare Fraud and Abuse

The for-profit home-health-care lobby in Massachusetts reports that Massachusetts' ultra-liberal Democratic United States senators -- Elizabeth Warren and something Markey (not sure I've ever heard his name given that he lives in Maryland) -- want the insurance company that runs Original Democratic-Party "as you know it" Medicare in Massachusetts to stop its crackdown on Medicare fraud and abuse. National Government Services, the subsidiary of the for-profit Wellpoint Insurance Company of Indiana -- which runs Medicare in Massachusetts is said by the lobby and/or the senators to impose an

"onerous medical review process relative to the Physician Face-to-Face Requirement"

included in the Democrats' own Medicare law.

Did Ted Kennedy Screw U.S. Taxpayers out of $400 Million as Gruber Claims?

One of the minor sub plots in Grubergate is Gruber's accusation that Ted Kennedy screwed U.S. taxpayers out of $400 million (or is it billion?). If you have seen that story, what you're reading about Ted Kennedy and Massachusetts is beyond misleading. For all intents and purposes, Ted Kennedy never even lived here in Massachusetts and certainly never had any major involvement in state issues. Like many people, he summered on Cape Cod (we here on Cape Cod thank you for the business but wish you would stay out of your cars once you get here; just walk the beach and leave the roads to us full timers).

The initial Massachusetts Medicaid waiver (circa 1998) was hatched under a Republican gubernatorial administration in Massachusetts (not Romney who had not parachuted in here yet to screw up the state) when there was a Republican Congress in Washington. I'm sure Senator Kennedy and the rest of our Democratic Congressional delegation did good constituent service to help smooth the waiver's way through a then Democratic administration in Washington.