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For Immediate Release:  April 10, 2006

What Every American Should Know about the Massachusetts Mandatory Health-Insurance Legislation

(Washington, D.C.)--Republican Governor Mitt Romney [has signed into law] this week a mandate that citizens of Massachusetts purchase health insurance, join a government-subsidized program, or face a financial penalty.

Romney's plan is being touted as landmark legislation and other states already are being encouraged to follow suit. But a close examination of the soon-to-become law reveals that it grants enormous power to special interest groups to collect health-care data on all citizens and impose fines on health-care providers who fail to share patients' data.

Following are some of the bill's lesser-known facts that all Americans should know about before endorsing the plan or expanding it nationwide. The bill:

  • Establishes a "health care quality and cost council" (referred to hereafter as the "Council") whose purported goal is to improve health-care quality and contain or reduce costs.

  • Grants the Council authority to promulgate rules and regulations requiring insurers and health-care providers to submit data to the Council. It also gives the Council authority to adopt bylaws for itself and its advisory committee, and makes clear that the Council is not subject to control of the Massachusetts executive office of HHS. Thus it is not clear (1) who has legal ownership of health data collected by the Council; (2) whether health data submitted to the Council will be personally identifiable or de-identified; and (3) with whom the data may be shared.

  • Imposes financial penalties on insurers and health-care providers who fail to submit .required data. to the Council on a timely basis (a penalty of $1,000 for each week of delay; a maximum penalty of $50,000).

  • Mandates that the Council shall consist of the following members:
    • the secretary of health and human services,
    • auditor of the commonwealth,
    • inspector general,
    • attorney general,
    • commissioner of insurance,
    • executive director of the group insurance commission, and
    • 7 persons to be appointed by the governor (including a representative of each of the following: a health-care quality improvement organization recognized by the federal Centers for Medicare and Medicaid services, Institute for Healthcare Improvement, Inc. recommended by the organization's board of directors, Massachusetts Chapter of the National Association of Insurance and Financial Advisors, Massachusetts Association of Health Underwriters, Massachusetts Medicaid Policy Institute, an expert in health-care policy from a foundation or academic institution, and a non-governmental purchaser of health insurance).

  • Requires the Council to establish an advisory committee with the following representatives:
    • Massachusetts Medical Society,
    • Massachusetts Hospital Association,
    • Massachusetts Association of Health Plans,
    • Blue Cross Blue Shield of Massachusetts,
    • Massachusetts AFL-CIO,
    • Massachusetts League of Community Health Centers,
    • Health Care For All, Inc.,
    • Massachusetts Public Health Association,
    • Massachusetts Association of Behavioral Health Systems,
    • Massachusetts Extended Care Federation,
    • Massachusetts Council of Human Service Providers,
    • Home Care Alliance of Massachusetts,
    • Associated Industries of Massachusetts,
    • Massachusetts Business Roundtable,
    • Massachusetts Taxpayers Foundation,
    • Massachusetts chapter of the National Federation of Independent Business,
    • Massachusetts Biotechnology Council,
    • Blue Cross Blue Shield Foundation,
    • Massachusetts chapter of the American Association of Retired Persons,
    • Massachusetts Coalition of Taft Hartley Trust Funds, and
    • additional members to be appointed by the governor which shall include, but not be limited to, a representative of the mental health field, pediatric health care, primary care, medical education, racial or ethnic minority groups concerned with health care, hospice care, the nursing profession and the pharmaceutical field.

  • Establishes a MassHealth payment policy advisory board that shall consist of the following:
    • secretary of health and human services,
    • commissioner of health care financing and policy,
    • 12 other members, including one member appointed by: the speaker of the house, president of the senate, Massachusetts Hospital Association, Massachusetts Medical Society, Massachusetts Extended Care Federation, Mass Aging Services Association, Home Care Alliance of Massachusetts, Massachusetts League of Community Health Centers, Mental Health and Substance Abuse Corporations of Massachusetts, Massachusetts Medicaid Policy Institute, Massachusetts Association of Behavioral Health Systems, and Planned Parenthood League of Massachusetts,
    • 2 members appointed by the governor,
    • 1 member representing managed care organizations contracting with MassHealth, and 
    • 1 member being an expert in medical payment methodologies from a foundation or academic institution.