Executive Director, Massachusetts Business Roundtable


Some

John Macdonald

of the biggest supporters of a new Massachusetts program that aims to expand health coverage are the businesses that are facing new costs and mandates as part of the initiative, John Macdonald, executive director the Massachusetts Business Roundtable, said.

Health expenses have increased so much over the years, Macdonald said, that companies are desperate for some way to control them.

"Costs are up dramatically and can't be passed through because there is now an entitlement mentality about health coverage," he said.

While parts of the Massachusetts plan are "not ideal," Macdonald said, the program includes a "market-based approach" that appeals to businesses and appears to hold the promise of making health coverage expenses more affordable and predictable.

Under the Massachusetts program,

• all Massachusetts residents, as of July 1, 2007, must prove on their state tax return that they have health coverage (as long as "affordable" coverage is available) or they risk financial penalties;
• all companies with 11 or more employees must offer their workers access to pre-tax purchase of insurance and make a "fair and reasonable contribution" to that coverage or they must pay a "fair share" assessment of as much as $295 per employee per year;
• a Commonwealth Care program offers state-subsidized coverage to individuals with incomes of up to 300 percent of the federal poverty level and businesses with 50 or fewer employees.

By focusing subsidies on those in need, the program, Macdonald said, takes a more rational approach than single payer or other plans that provide state-sponsored benefits for everybody.

"With all due respect to Fidelity fund managers, they don't need our help getting physicals or buying drugs," he said.