New Mass. Health Insurance Law Would Force Some to Buy More Coverage

More than 200,000 Massachusetts residents who already have health insurance would be forced to buy additional coverage to meet the proposed minimum standards under the state’s new health insurance law, according to insurers.

Most of those in question either do not have prescription drug coverage or have drug coverage that is below the minimums proposed by the state board implementing the law.

The Commonwealth Health Insurance Connector board is scheduled to vote on the standards in March. Those who do not have insurance that meets minimum standards could be fined.

“It’s very troubling,” said Richard Lord, president of Associated Industries of Massachusetts and a member of the Connector board. “The new law was about expanding access for people without any health insurance. I don’t think we should be forcing people who do have some coverage to spend more.”

The new number released Monday includes only those covered by the five largest Massachusetts insurers.

The minimum standards are still under review. The board postponed a decision last week because of concern about the cost of the basic plans, an average of $380, which the board considered unaffordable. They were also far above the $200 cited by former Gov. Mitt Romney before the law was passed.

Under the law, adults must obtain coverage that meets the minimum standards by July 1 or pay a penalty, unless they can prove they can’t afford insurance.

The proposed standards would require insurance plans to provide “reasonably comprehensive coverage,” including primary care, emergency services, hospitalization benefits, mental health services, and prescription drugs.

Jon Kingsdale, executive director of the Connector, said the new estimate of the underinsured would be useful when the board revisits the issue of minimum standards.

The new figures were compiled by the Massachusetts Association of Health Plans, based on a survey of five Massachusetts insurers who control about 90 percent of the insurance market: Blue Cross Blue Shield, Harvard Pilgrim Health Care, Fallon Community Health Plan, Health New England, and Tufts Health Plan.

The numbers do not include people insured by national companies, including United HealthCare Insurance Co. and Aetna.

“We think this is taking health care reform backwards,” said Dr. Marylou Buyse, president of the association.

She said proposed minimum requirements are like “forcing everybody to buy a Cadillac. There are a lot of people who don’t pay for high-benefit plans. They don’t want them, and they don’t want to pay for them.”

Lord was also worried that the proposed standards might lead businesses to drop insurance coverage rather than offer employees more extensive and expensive plans.