May 5, 2006

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May 5, 2006 The Honorable Mitt Romney Massachu
setts State House Office of the Governor Room 36
0 Boston, MA 02133 Dear Governor Romney
  The plans we represent are all Massachusetts-b
ased, not-for-profit companies serving over 4.5
million members and employing thousands of
workers throughout the state. We are proud that
U.S. News World Report and the National
Committee for Quality Assurance rank our plans
among the top ten health plans in the nation for
member satisfaction and quality of care.
  We are writing to express our serious concerns
about the impact of legislation currently being
considered by Congress which will seriously
undermine the historic health care achievements
that you and legislative leaders have made here
in Massachusetts.   S. 1955, The Health Insur
ance Marketplace Modernization and Affordability
Act of 2006 sponsored by Senator Michael Enzi,
may be considered by the full Senate during the
second week of May. We urge you to oppose this
legislation. We are particularly concerned about
the Enzi legislation as it relates to rating
requirements. If Enzi were to become law, it
would allow medical underwriting and premium
surcharges based on age, gender, geography and
group size in the small group market in all 50
states.   While a few young and healthy individ
uals may find insurance products more accessible,
those who need it most will not. Under
Massachusetts law, and the laws of other states
with modified community rating, individuals and
small employers are protected from the price
spikes that occur when health status is
considered as a factor. The price variances
between those who are healthy and those who may
suffer a health condition are dramatic and will
impact people when they need health care most.
S. 1955 will also have an adverse impact on small
employers with older employees. Again, the
impact will be felt the most in states with
modified community rating, where it is expected
that there will be a rise in the number of
uninsured as a result of the implementation of S.
1955.
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It is worth noting that in nine of the ten states
that have community rating, the percentage of
businesses that offer health insurance is higher
than the national average. States with community
rating also have uninsured rates below the
national average. The Enzi legislation will t
hreaten the strides that Massachusetts has made
with the newly enacted health reform law, and
could in fact dismantle this historic effort over
time, specifically as it relates to market
reforms. In the short-term, Enzi will create a
serious dispute as to whether states will follow
their own state statutes or the new federal Enzi
provisions. This conflict will likely be
resolved only by the courts after protracted
litigation. In the long term, the Enzi
legislation will stymie state efforts to seek
innovations in health reform and instead will
place the regulation of most insurance matters
firmly within the domain of the federal
government.   Given the importance of the upco
ming Senate vote, we hope you will reach out to
the Massachusetts Congressional delegation to
voice your opposition to the Enzi bill. We also
urge you to contact your fellow governors and
alert them to the fact that the federal
legislation will chill innovation at the state
level and limit a states authority over
insurance matters. Thank you for your conside
ration of this important matter.
      James Roosevelt, Jr. Cleve L. Kill
ingsworth President and CEO President and C
EO  
  Charles D. Baker Eric H. Sc
hultz President and CEO President and
CEO cc Senator Edward M. Kennedy Sena
tor John F. Kerry