Massachusetts Gov. Deval Patrick (D) on Saturday announced that health insurers will offer basic coverage for as low as $175 per month for individuals under the state's health insurance law, the Boston Globe reports. Under state law, residents must obtain health insurance by July 1 or face penalties. Earlier bids for individual minimum coverage plans averaged $380 per month, which health care advocates said was unaffordable for many residents, according to the Globe. Under the lowest-cost plan, to be offered by Neighborhood Health Plan, coverage for individuals ages 35 to 39 will cost $175 per month. The basic plan for individuals will cover preventive care, office visits, hospitalization and prescription drugs. Basic coverage plans would have annual deductibles of $2,000 for an individual and $4,000 for a family, according to the Globe. Similar plans will be offered by the state's three major insurers with monthly premiums for residents between the ages of 35 and 39 ranging from $241.68 for individual coverage from Tufts Health Plan to $288.31 for individual coverage from Harvard Pilgrim HealthCare. Health insurance plan premiums will vary by age, location and comprehensiveness of coverage (Krasner, Boston Globe, 3/4). The minimum plan would cover the majority of uninsured Massachusetts residents, whose ages average 37 years old, the AP/Boston Herald reports. The Commonwealth Health Insurance Connector, which is responsible for overseeing the insurance law, is expected to approve the plans at its meeting on Wednesday.

Reaction
Patrick in a statement said, "This is a big improvement from the first round of bids and a big step forward for health care reform" (AP/Boston Herald, 3/3). He added that the lower premiums negotiated put "us an important step closer to universal coverage." Affordability has always been a critical feature of the health care reform plan." Charles Baker, CEO of Harvard Pilgrim Health Care, said, "The governor basically said: 'We're interested in seeing more affordable options. Can we work together to try to pursue a course that gets us there in a month or so? My answer was yes." Thomas Glynn, COO at Partners HealthCare, said, "We're back in the ballpark. At $380, people were worried that health care reform wasn't going to work. I think this should reassure people that we have a workable plan" (Boston Globe, 3/4).

High Deductibles
In related news, the Globe on Monday examined the impact of the high deductible component of the newly-negotiated plans. Connector board members have said that the high deductibles are necessary to reduce monthly premiums to an affordable level. However, research shows that high deductibles can result in people forgoing needed medical care, including preventive care, and acquiring large amounts of debt. The Connector board has proposed that minimum plans' requirements include coverage of at least three preventive care visits before the deductible begins and a cap on out-of-pocket spending at $5,000, including the deductible and copayments of $100 or more. Jon Kingsdale, executive director of the Connector, said that the proposed deductible "seemed high by our standards in Massachusetts, but something people could stomach" to keep monthly premiums down. Kingsdale added, "We're not endorsing a high deductible. We're placing a limit on deductibles." Nancy Turnbull, president of the BlueCross BlueShield of Massachusetts Foundation, said, "The state is going to have to make some difficult tradeoffs between comprehensiveness of benefits and affordability of coverage, at least in the short run." She added, "High deductibles are a blunt and crude way to make coverage affordable. In the future, I hope we can find other ways." Jonathan Gruber, an economist at the Massachusetts Institute of Technology, said, "The main thing is no one should be bankrupted by medical costs in Massachusetts. Let's get [the uninsured] into the system and get them real insurance, and then maybe they'll be interested in buying something better" (Dembner, Boston Globe, 3/5).