The Municipal Healthcare Crisis: What Is It Worth to You?

Posted in Alerts

Ten years ago legislative leaders and local officials in Massachusetts signed into law key pieces of legislation that provided communities tools to help relieve increasing property tax pressures. The Municipal Partnership Acts allowed municipal employees, retirees and their dependents the option of joining the State's health insurance plan which resulted in financial savings. This Reform necessitated increased collaboration between municipal leadership and unions at a time when localities faced unprecedented rising healthcare costs and, consequentially, strains on their budgets. The cities, towns and school districts that took advantage of this Reform saved jobs and avoided tax increases.

Certain aspects of the Reform are still viable, others have expired. The momentum this Reform gained and the public discourse that surrounded municipal health insurance in general has quieted for reasons likely attributable to a shift in public policy priorities in Massachusetts. But countless stories are emerging from communities facing greater increases in their healthcare expenditures. Many are again struggling to address this problem. Today, the municipal healthcare crisis is quickly becoming an epidemic for mayors and town managers.

Traditional collective bargaining practices during annual negotiations often limit the scope of plan design examinations. This contributes to municipal health insurance plan design remaining stagnant while the private market continues to rapidly evolve. An aging population, new and innovative approaches to health management, rising prescription drug costs and data analytics are not as progressively evaluated within the municipal market, a process that could potentially avert a crisis.

Gloucester, Mansfield, Northbridge, Newburyport, Weymouth and school districts such as Attleboro, Norton and Worcester are currently struggling with insurance cost increases as high as 30 percent.

Granted, you'll see a mix of increases and decreases statewide, but each case is distinct in how these costs affect their hometown. The pain felt on school districts across the Commonwealth has been public facing over the past several months with many business managers fearing increased rates that will impact school programs and classrooms adversely.

And, this “pain” is being felt far beyond the Commonwealth. Towns in Connecticut, Michigan, New Jersey and New York are struggling to address the negative impact of rising municipal healthcare costs within their jurisdictions. Even Canada’s socialized system is not immune. Officials in Brockville, Canada, recently testified that a significant burden is being placed on property tax payers in order to cover rising municipal health costs in the surrounding provinces. This would suggest that the current municipal health system is becoming unsustainable.

For several years I have worked with many communities,helping to facilitate healthcare negotiations across the Commonwealth during the peak of the Municipal Health Reform.  I would like to offer a prescription to inspire an approach that's founded on the type of collaboration the Reform successfully nurtured for many years. I realize a healthy dialogue alone will not be enough to solve the problem though. We need to involve both the industry and our communities in the solution. Actively becoming more educated about this issue and how it affects your community through attending town meetings, public hearings and/or engaging with your legislators are all ways you can influence the solution. The end goal: construction of a health care system that is effective and sustainable without diminishing the level of care or services for our neighbors.

And it’s about to get personal. Your home town healthcare costs may ultimately consume as much as 20 percent of your local budget. Your kids may risk losing their favorite teacher or end up in overcrowded classrooms. You may suffer unwarranted property tax increases and other costs that will impact your personal budget. Are you prepared to subsidize the fast-approaching municipal healthcare crisis?

Danielle is a resident of the Town of Brookline.

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