Health Affairs Report On Mass. Mandatory Insurance Law Confirms: Strong Public Option Must Be Included in National Health Reform

/PRNewswire / -- A study released today in Health Affairs finds that a Massachusetts law requiring all to show proof of health insurance has resulted in higher costs. This predictable result confirms that President Obama's promised "public option" to private insurance must be a part of national health reform, said Consumer Watchdog.

Consumer Watchdog said that Massachusetts' experience shows that reform is unaffordable without a public option like Medicare in competition with for-profit insurance companies. Unlike Massachusetts which is dominated by non-profit insurers, the mandatory purchase approach would be much more damaging if applied nationally, where most HMOs and insurance companies are for-profit and take 25% or more of premium charges for overhead and profit.

The Massachusetts law, similar to proposals pushed by health insurers at the national level, requires every person to either buy an insurance policy or show proof that an employer provides one, but does not regulate what insurers can charge. The state does not limit health insurance overhead and profit, and does not limit how much people have to pay out-of-pocket when they get sick. As result, the study released today found that the number of adults "who reported that they did not get care that they thought they needed" has increased due to the proliferation of high-deductible health insurance policies that require patients to pay up to thousands of dollars out-of-pocket before accessing care.

"Under the mandatory purchase approach, particularly one that does not provide a public option to for-profit insurance companies, patients might be technically 'insured' but will not receive the coverage they need when they get sick," said Jerry Flanagan, Health Care Policy Director for Consumer Watchdog. "National health reform must provide the American public an option to buy coverage through Medicare whose low-overhead costs provide the most health care for our dollar. Competition with a low-cost alternative will help keep the likes of WellPoint, United Health, and Humana in check."

According to Consumer Watchdog, the biggest advantage of a voluntary public option is that it is inexpensive to administer. Medicare's low administrative overhead costs (2 percent) are well below the overhead costs charged to large companies that are self-insured (5 to 10 percent of premiums), companies in the small group market (25 to 27 percent of premiums), and individual insurance (40 percent of premiums).

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