New England is nation’s health care reform laboratory

New England is proving to be the nation’s health care finance reform laboratory.  In 2006, Massachusetts set up a state-run health insurance exchange and required all residents to have public or private coverage for medical expenses.  Those two essential elements of the Massachusetts legislation became the template for the federal Patient Protection and Affordable Care Act (PPACA) signed into law last year.  Barring intervention by the U.S. Supreme Court, those basic components of the Massachusetts plan will become the law of the land in 2014.

The latest New England health care finance experiment was launched this week with the signing of legislation that will put the state on a path to becoming the sole payer of all medical bills, known as “single payer.” The legislation creates Vermont’s state run insurance exchange, Green Mountain Care that opens for business on Jan. 1, 2014.  Under the legislation, three years later the state — and not private insurers and health plans — would cover health care costs of all state residents.

The legislation calls for Vermont to obtain a waiver from federal officials under a PPACA provision allowing states to offer “innovative” health plans starting Jan. 1, 2017 provided the plans provide coverage that is at least as comprehensive as required for plans offered through health benefit exchanges and provide coverage to a comparable number of state residents.

In California, legislation to create a single payer system called the California Healthcare System is stalled for the rest of this year, having failed to meet a deadline this week to pass out of a legislative committee charged with estimating the bill’s cost.


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email or call 530-295-1473. 

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Frederick Pilot

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