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The Boston Globe
Boston Globe Online / City & Region
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Romney outlines health care plan

Proposes new fees for higher-income Medicaid patients

By Stephanie Ebbert, Globe Staff, 8/7/2002

Republican gubernatorial candidate Mitt Romney yesterday proposed overhauling Massachusetts' health care system, in large part by charging copayments to higher-paid Medicaid recipients.

In his latest PowerPoint presentation on a policy initiative, Romney said he could expand coverage to more people by assessing fees on a sliding scale to participants on the higher end of the income limits.

''We're not looking to increase the costs of MassHealth,'' he said, referring to the program funded by Medicaid funds. ''Nor are we looking to reduce it. We're looking instead to use our dollars more effectively in covering a larger number of people.''

Health care advocates panned the proposal, saying recipients could never contribute enough to make it work.

A family of four at the top of the scale can make no more than $36,000 to qualify. An individual is disqualified if he or she makes more than $17,724.

''Charging them premiums is just not going to get you there,'' said Joshua Greenberg, a deputy director for Health Care for All, an advocacy group.

Romney did not say who would be charged copayments or specify how much they would be charged. His spokesman, Eric Fehrnstrom, said later that since 1 million Massachusetts residents are covered by the program, the copayments would add up.

''Mitt has simply enunciated the principle of instituting copays,'' Fehrnstrom said. ''If elected, Mitt is going to bring all the interested parties to the same table. We will hash out the details ... It's not unlike the revolution in thinking on welfare.''

Down the hall from Romney's presentation in the Omni Parker House, Democratic Party chairman Philip W. Johnston held a press conference to criticize Romney's plan as a ''right-wing, radical proposal.'' Johnston, a health care lobbyist himself, was still unclear on the details, believing that Romney was imposing sliding fees for insurance premiums. But he also criticized Romney's proposal for tort reform, saying it would dramatically restrict patients' rights to sue for malpractice.

''It's the most anti-consumer proposal we've seen,'' Johnston said.

As Johnston spoke, he was shouted down by Fehrnstrom, who entered the press conference and disrupted it with questions. Fehrnstrom slammed Johnston for Johnston's own tenure as former governor Michael Dukakis's Health and Human Services secretary and argued, ''You're advocating for a return to universal health care and a return to unfunded mandates.''

Fehrnstrom himself was shouted down by several reporters who said they needed to ask Johnston questions. The unusual exchange broke tradition for the gubernatorial campaigns, which have been sending volunteers to observe and videotape events hosted by their rivals and their parties, but not arguing in public.

Romney noted during his speech that he had suddenly become very familiar with Massachusetts health care. His wife, Ann, underwent an emergency hysterectomy at Brigham and Women's Hospital on Monday, and was recovering well yesterday, he said.

Some of Romney's proposals seek to benefit consumers - providing consumer health guides with cost comparisons, establishing a ''health hot line'' to eliminate unnecessary trips to the doctor, and creating a more user-friendly and streamlined Health and Human Services.

Other initiatives were aimed at cutting health care costs growing at four times the rate of inflation. This year the Legislature cut Medicaid benefits for 50,000 childless and chronically unemployed residents, yet Medicaid costs still rose more than 9 percent, driving a ballooning budget.

Romney said his program would extend favored prescription pricing in Prescription Advantage, the state's drug plan for the elderly and disabled. Romney declined to state a position on whether state employees should contribute more money to their own health care coverage.

He also focused heavily on Massachusetts' low federal reimbursement rate of roughly 50 percent, saying Massachusetts needs to increase its share of federal funding. He suggested politics were at play and he could negotiate a better rate; a 77 percent reimbursement would raise $1.7 billion annually, he said.

But the rate is set by formula, driven by poverty rates. Massachusetts' high per capita income makes it impossible to budge, health care advocates said.

He also aimed to preserve the health care industry, which he noted is Massachusetts' largest employer, and to cut red tape and to end ''defensive medicine'' that safeguards against malpractice suits.

Stephanie Ebbert can be reached at

This story ran on page B5 of the Boston Globe on 8/7/2002.
© Copyright 2002 Globe Newspaper Company.

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