Fast Focus
	The Bay State is still afloat, more people are insured, and by all accounts brokers who specialize in health insurance are doing well.
	Massachusetts officials are struggling to bring costs under control, an effort that might rely more heavily on government influence.
	The complexity of the healthcare reform law works to the advantage of those, like brokers, who understand it.

Mirror Image? Romneycare vs. Obamacare

If Massachusetts health insurance reform is a precursor to Obamacare, then look for a system that will work but will result in rising costs and maybe more intense broker interaction.

By  Ed Leefeldt

Phil Edmundson, CEO of Boston-based William Gallagher Associates, gets tired of defending his home state’s healthcare plan. “Every time I go to an out-of-state meeting,” he says, “the first thing they ask is, ‘Just how bad a budget buster has it turned out to be?’”

Truth is, it hasn’t. The Bay State is still afloat, more people are insured, and by all accounts brokers who specialize in health insurance are doing well. Edmundson credits former Republican governor Mitt Romney and his negotiating skills for making Romneycare—as it is referred to with both respect and derision—happen in 2006.

“Governor Romney was very smart,” Edmundson says. “He took the good ideas from both sides of the aisle and made them work.” But ask Edmundson about the 2010 Affordable Care Act, aka Obamacare, and he’s not so sure.

The Massachusetts microcosm was the out-of-town tryout for bringing Obamacare to the national stage. The similarities, as a checklist on thinkprogress.org shows, are obvious. Are individuals mandated to get it? Yes and yes. Do employers have to assist them? Yes and yes. Are there health exchanges for those who don’t fit into employer plans or don’t want to? Yes on both counts. And the list goes on.

“Massachusetts is trying to be the poster child for healthcare reform,” says broker Vinnie Daboul, who has been involved in employee benefits for many years. “There’s not a lot you read about that doesn’t reference us.”

Democrats clearly studied the Romney playbook when they passed the Affordable Care Act. And they are not shy about admitting it, even holding thank-you parties in his honor and sending him messages on Twitter.

In contrast, Republican Romney has disowned his child. He doesn’t like to talk about it. And when he does, he criticizes it, saying in his book No Apology that what works in Massachusetts might not work in Texas or California.

Meanwhile, Massachusetts officials are struggling to bring costs under control, an effort that might rely more heavily on government influence. A recent study by Lockton, the largest privately held independent broker, shows that many employers, particularly in the retail, restaurant and entertainment industries, might terminate their health plans or fire workers in coming years.

The one certainty: Brokers will play a key role in helping clients and companies understand this new world of health insurance. To succeed, they’ll have to stay ahead of the health insurance curve, know where the sweet spots are and how to hit them, and avoid the “commodity” end of the spectrum that may be taken over by the low-budget health exchanges. There’s still time, even in early-entry states like Massachusetts. But eventually time will run out.

Confluence of Events

Recent events have made this a particularly good time to revisit healthcare, a subject Leader’s Edge tackled in May 2010. The 2006 Massachusetts Health Care Reform Plan now has five years of flawed but not fatal history, so the Bay State’s successes, failures and prospects provide a cloudy but important view of how the national healthcare plan will look when most of its key provisions take the national stage in 2014. Recent studies show what has and hasn’t worked.