The CommCare/MMCO Contract Fracas

Globe’s Alice Dembner does a fine job in today’s article outlining the contentious renegotiation between the Connector and the four Medicaid Managed Care Organizations (MMCOs) to manage coverage for the 177,000 enrollees in Commonwealth Care.

The Commonwealth wants to keep the cost of CommCare in FY09 as close to the $869 million projection in Gov. Patrick’s proposed budget as possible. Folks in the four plans think that’s not possible given the expected growth in enrollment and the projected costs of caring for this formerly uninsured population. Monthly costs per enrollee in CommCare now are in the range of $360.

A lot at stake. Negotiations such as this often get contentious. We hope both sides are able to work it out. And we hope they’ll take to heart Celia Wcislo’s comments at the conclusion of Alice Dembner’s piece:

“If the bids are high, extreme copay and premium increases for low-income families are not a morally or fiscally sound solution,” she said. “Massachusetts healthcare reform, which has been successful so far, was built on a foundation of shared responsibility.”

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2 Responses to The CommCare/MMCO Contract Fracas

  1. Ron Norton says:

    Ann,

    I agree, it is time to drop the “shared responsibilty” tag line and call it what is really is: “widespread pain”!

  2. Ann Malone says:

    RE: Celia Wcislo’s comments at the conclusion of Alice Dembner’s piece: “Massachusetts healthcare reform, which has been successful so far, was built on a foundation of shared responsibility.”

    How ’bout this: let’s have a fuller conversation and add a few more of Celia’s words that she posted recently on the wbur blog Commonhealth:

    “A sense of shared responsibility is what has made reform a success thus far. That sense of shared responsibility must not be allowed to erode. With rough waters ahead, simply asking consumers, the state, and taxpayers to row harder won’t cut it.”

    Whaaaaat????

    The shared responsibility is an illusion; all but the poorest among us continue to get a raw deal and for many it has made things worse as they face tax penalty fines for being uninsured.

    It’s long past time to take an honest appraisal of this situation. With all due respect, “rough waters ahead” disregards the reality that the health care crisis rough waters have been swirling all around us (drowning some) for a long time now, and that much of the Chapter 58 law and its fake reform is making things worse. Yes, coverage is better for some but this has come at a high cost that taxpayers and the state can not sustain, and for the hundreds of thousands who remain uninsured, they will be getting fines of up to $912.00 a year for the crime of not being able to afford to buy an insurance policy.

    Celia is a past president of a large union local of SEIU and she’s now on their executive committee. SEIU 1199 has a lot of political clout and other resources that could go a long way to advance meaningful health system reforms.

    What do SEIU and other union members have to say about propping up the current flawed and failing (not failing for the insurance companies, just for us) health care system as is being done with the Chapter 58 law? This must be particularly painful when a contract comes up for renewal and hard workers are faced with bargaining away deserved wage increases in an attempt to hold down workers’ health care costs or to protect retiree health benefits.

    The health care system is corrupted by the profit motive and corporate control of what should be treated as a public good, not as a commodity to be bought and sold in an artificial marketplace. We need organized labor to help us change that, not to build on it. If Celia or other union members read this, thank you for considering what is a very sincere request.

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