BOSTON — The state Senate has passed legislation intended to bring Massachusetts into compliance with the federal Affordable Care Act while simultaneously instructing the Patrick administration to seek a waiver from the Obama administration on a key provision of the federal law set to take effect next year.
But Senate Minority Leader Bruce Tarr, the Gloucester Republican, said the legislation that cleared the Senate was at cross-purposes by both seeking to avoid the federal requirement while providing for a phase-out of the five additional state rating factors, a fallback that he said brought into question the “candor” of the move to secure a waiver.
The Senate unanimously backed a waiver from the Affordable Care Act’s insistence that states limit rating factors used to calculate small group premiums to four considerations – age, family size, geographic area and tobacco use. State law allows for additional consideration of industry, participation rate, group size, intermediary discount and group purchasing cooperatives.
Business groups, such as the Associated Industries of Massachusetts, and others worry that the new rating system could increase the premiums for as man as 60 percent of the state’s small businesses, though, in some cases, the new system could reduce premiums. The directive to seek a waiver is not in the House version of the bill.
Senate Chairman of Health Care Financing James Welch, a West Springfield Democrat, said that merely seeking the waiver without providing a plan to implement the federal law without the waiver would “inject instability” into the market, while Tarr called the legislation a “usurpation” of the state’s policies.
The Senate legislation clears the path for an expansion of MassHealth, priming the state for the 2014 implementation of the federal health care law. The ACA drew in large part from the Bay State’s 2006 law, which imposed an individual mandate requiring Massachusetts residents to obtain insurance.