“Pain in the Massachusetts Health Insurance Market”

The Merged Market Advisory Council has discovered that plans with a limited network tend to provide better service at a more affordable price. They also offer the same service as plans with a wider network, but at a lower cost. Although network-only plans appeal to many individuals as a more budget-friendly option, small businesses aren’t always attracted to them. This is where the Health Connector for Business comes in. This organization provides small employers with a range of both narrow and wide network plans. In addition, they offer a 15% rebate which can save small businesses thousands of dollars.

The cost of federal health insurance has been increasing steadily, and this is a matter of concern. High prices aren’t due to state or federal health care reform, consumer protection, or the consolidation of individual and small-group insurance markets. The Health Connector and other state partners are committed to working with small businesses to tackle this issue and make it more affordable.

Amidst the ongoing debate, the state’s single-payer plan is an apparent solution that has not been acknowledged. The Editorial, “Small Business Health Insurance Market Faces ‘Death Spiral’,” brings up the urgent and complex issue of corporate ownership in Cape Cod. The piece does not, however, consider a single-payer insurance scheme as a possible solution. The proposed Medicare for All bill can provide all residents with comprehensive benefits that exceed what is offered by private insurance. There aren’t any deductibles or copays, and no restrictions to networks. Individuals are free to choose their providers. The funding for this plan will come from a predictable 2.5% employee health tax, along with a 7.5-8% employer tax. There are no surprises or yearly benefit renegotiations.

Small businesses are less constrained with employment decisions since they don’t have to consider which insurance their potential employees will be offered. Currently, access to primary care is a significant challenge. The submission of competing health plans, which have different models for making a profit, makes primary care unmanageable with coding, electronic record-keeping, claim reporting, pre-approvals, and disputes. Given that reimbursement rates are relatively low and paperwork is unpaid work, even individuals with reportedly good insurance struggle to get primary care. Tax-funded universal healthcare is being considered, and it needs to be evaluated and discussed.

The Health Connector for Business and other state partners strive to support all incomes and small businesses, with programs and services that make healthcare more accessible. As the state works to address underlying healthcare costs, these efforts will continue and expand. Audrey Morse-Gasteier, Executive Director of Health Connector Boston, Massachusetts, emphasizes the importance of improving healthcare affordability for small businesses and overall economic competitiveness. Brian O’Malley, a retired primary care physician for over 40 years, is Provincetown’s representative to the Cape Cod Local Government Delegates since 2015.

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