By Al Norman
No one should be forced to enroll in a health plan they did not freely choose to join.
Yet that’s what lawmakers on Beacon Hill are trying to do. Legislation is under consideration that would automatically enroll more than 130,000 low-income seniors on Medicaid into managed care plans they did not choose.
They would be locked into a plan with no way out for 90 days. Only after three months would they be allowed to disenroll.
Because this is such a blatant coercive act, the bill uses the term “passive enrollment with an opt-out” instead of the words “forced enrollment.” Ask anyone on the street what “passive enrollment with an opt-out” means, and watch the confused answers.
The legislation, H. 4052, must be acted upon by June 8. It is currently in the legislature’s Joint Health Care Committee. The theory behind the bill is that it will save the state millions of dollars by forcing elders into managed care. It doesn’t matter that they might have to give up their doctor or specialist. It doesn’t matter that their hospital may not be participating in the plan. This is being done for the convenience of the state — not for the needs of the consumer.
And that’s precisely where this bill goes wrong. All health care plans should be consumer-centered, not provider-centered. If a plan offers excellent benefits, let seniors freely choose to join in. I like to think that seniors are smart enough to make their own decisions about which health plans they like, rather than having lawmakers on Beacon Hill directing them into plans they do not want.
To make matters worse, during budget debate, the House adopted a similar ‘passive enrollment’ plan. As a result, this idea of forcing people into health plans they don’t want is now before the Senate.
The fact is: Medicare law does not allow seniors to be deprived of their access to what is known as “fee for service” Medicare. That is the original Medicare — in which you don’t have to look over the list of doctors and hospitals, because there is no limited network to deal with. Congress would first have to change this law — and I hope they never do.
In addition, current federal law does not allow any savings that these managed care plans create for Medicare to remain with the state. Medicare is a federal program, and any savings they keep. One study from 2008 said that if Massachusetts forced seniors into the managed care plans, it would cost the state $989 million in the first 12 years of the plan.
Some seniors love managed care plans. They are free to join them. The point is, it should be your choice alone which plan makes sense for you. In many parts of the state these managed care plans do not even have an office or a network.
We have to actively oppose this “passive enrollment” proposal. Please cut this article and send it to your state senator. If you don’t know who that is, call me and I will tell you who your senator is. Don’t be herded into a plan you don’t want.
Al Norman is the Executive Director of Mass Home Care. He can be reached at 413-773-5555, or at info@masshomecare.org.
