April 21, 2009
The Honorable John F. Kerry
304 Russell Senate Office Building
Washington, DC 20510
Dear Senator Kerry:
At Blue Cross Blue Shield of Massachusetts, we share President Obama's vision to "bring together businesses, the medical community, and members of both parties around a comprehensive solution" to the health care crisis facing the nation. As you confront this challenge on a national level, we hope we can be helpful in providing our insight and experience as a health plan that wholeheartedly participated in the development and passage of our successful health care reform law in Massachusetts.
Blue Cross Blue Shield of Massachusetts was pleased to play a supportive role analyzing complex issues and modeling the impact of potential solutions during the development of health care reform in Massachusetts. The ability of policymakers in Massachusetts to bring health care to virtually everyone while not causing great disruption to the private insurance market cannot be overstated.
Our experiences and thoughtful consideration of health care reform issues being discussed in Washington have led us to certain conclusions about the potential for a public plan option at the national level. While advocates of a public plan option contend it would not have a negative impact on private health insurance, this is simply not true. The private insurance market and the health insurance that is being purchased today by more than 160 million Americans will change as a result of the impact of a public plan option.
A public plan threatens the employer-based system of coverage that insures most Americans. The Lewin Group estimates that more than 118 million people would shift to a government plan almost immediately. Moreover, Medicare and Medicaid have consistently underpaid providers who then demand that private insurers make up the difference. A public plan option would exacerbate the existing trend of cost shifting to the private sector and cause private health insurance costs to rise.
Blue Cross Blue Shield of Massachusetts has a well-earned reputation of providing the highest levels of service and quality to our members, as reflected in rankings by the NCQA and J.D. Power and Associates. However, a public plan would threaten the good work of high-quality, single-state, non-profit health plans like those in Massachusetts. It would force smaller, non-profit plans to unfairly compete with large, national, for-profit competitors against the federal government and be potentially faced with a risk pool in Massachusetts that would raise costs in the local market.
A strong private insurance system is integral to designing and implementing needed delivery system reforms to ensure that we have a high-quality, high-value health care system. The private market has the ability and agility to innovate unencumbered by political pressure or changing Administrations.
Massachusetts was able to extend health care coverage to 97.5% of its population without the need for a public plan. We believe that market changes and system reforms would accomplish the same goal as a public plan with far less disruption to the health care delivery and payment system.
Finally, as you consider other issues pertaining to national health reform — including Connectors or market reforms — we ask that you remember the great access achievements in Massachusetts and make every effort to do no harm to our historic expansions. States like ours that have innovated to find affordable and workable solutions to health care reform on behalf of individuals and employers should be rewarded, not penalized, for their initiative. Our members — your constituents — deserve no less.
Thank you again for your dedication to our shared goals of providing access to affordable, quality health care for all citizens throughout Massachusetts and the nation. We look forward to continuing to work with you and remain hopeful that Congress will enact meaningful health care reform on the national level that builds on the current employer-based system without the need to create a public plan.
Sincerely,
John J. Curley, Jr.
