How Obama Law Compares With Medicare Part D, Mass.

By Louise Radnofsky

June 20, 2013, 6:28 PM

In the debate around the readiness of the federal government to roll out the big provisions of the health-care law on time this fall, there are a couple of particularly popular comparisons: the launch of the Medicare part D prescription drug benefit in 2006, and the implementation of the Massachusetts of the state health-care overhaul for a launch in 2007.

The program was one of the biggest efforts the Centers for Medicare and Medicaid Services (or any part of the federal government) had taken on since the launch of Medicare itself in 1965. Supporters of the law point to the popularity of that program now. Skeptics say that the Part D benefit was far easier to administer than the health law, because it chiefly involved seniors already in the program, pharmaceutical companies and insurers, and a single government agency in charge.

A new paper from the Robert Wood Johnson Foundation, a research nonprofit that supports the health law, makes several specific comparisons to fuel future conversations:

- Polls ahead of the Part D launch showed that more people felt unfavorably about it than liked it.
- There were big questions about whether enough insurers would participate.
- Everyone was worried that the IT systems and plan reviews wouldn’t be ready on time.
- Pricing was a big worry.
- States were grumbling about the regulatory and cost burdens they would face under the part D program.
- The publicity campaign was daunting and consumers were confused by the options available to them.

RWJF concludes: “Past efforts to design and launch a large national health coverage program suggest that the experience will be far from perfect, at least at the outset. However, the Medicare Part D experience teaches us that, when things went awry, federal and state officials were often able to identify problems and work with stakeholders to develop policy and operational solutions, so that consumers could obtain the promised benefits.”

One other comparison often cited is to Massachusetts, whose program involved many features that are similar to the federal health-care overhaul.

Andrew Dreyfus, CEO of Blue Cross Blue Shield of Massachusetts, throws out an important caveat about that, though. The state law had bi-partisan support, he notes, meaning that legislators could make technical fixes when they needed to — and there was a broad coalition of providers, activists and officials committed to making it work.

“The biggest difference was that the community was behind it,” he said.

Correction: The new Robert Wood Johnson Foundation paper discussed Medicare Part D. The initial version of the headline of this article incorrectly said it also discussed the Massachusetts health law.

http://blogs.wsj.com/washwire/2013/06/20/paper-compares-obama-law-with-medicare-part-d-mass/