What Universal Coverage Means in Massachusetts

Thousands of consumers are gaming Massachusetts’ 2006 health insurance law by buying insurance when they need to cover pricey medical care, such as fertility treatments and knee surgery, and then swiftly dropping coverage, a practice that insurance executives say is driving up costs for other people and small businesses.

In 2009 alone, 936 people signed up for coverage with Blue Cross and Blue Shield of Massachusetts for three months or less and ran up claims of more than $1,000 per month while in the plan. Their medical spending while insured was more than four times the average for consumers who buy coverage on their own and retain it in a normal fashion, according to data the state’s largest private insurer provided the Globe.

Full article on the gaming of Massachusetts’ health care system.

Comments (5)

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  1. Joe S. says:

    I believe this is only the beginning. Once people understand that not having insurance means that they pay a nominal fine (if any) and that if they get sick they can always go get coverage at no extra cost, there will be many more gaming the system.

  2. Larry C. says:

    Some insurance friends of mine have been telling me about this for some time, but this is the first time I have seen it discussed in public.

  3. Virginia says:

    I agree. It completely violates the fundamental principles of a well-functioning insurance market.

  4. Devon Herrick says:

    Massachusetts offers many lessons for what NOT to do with our health care system.

    1) It’s easy to enroll people when coverage is free; but difficult when you expect people to pay for it.

    2) If the penalty is low and enforcement non-existent, expect people to forgo coverage.

    3) People will game the system and sign up for coverage long enough to get the care they need and drop afterwards.

  5. Neil H. says:

    This is how death spirals begin. As the pool gets sicker, prebmiums rise and then more healthy people drop out and premiums rise even more …….