Massachsetts cities, towns, schools embrace insurance overhaul

More than 125 cities, towns, and school districts in Massachusetts have taken steps to adopt municipal health insurance reform options made available under a 2011 law or recently used collective bargaining to shave health care costs, according to an update on the law, which estimates savings to date have reached $80 million.

The two-page update from the Massachusetts Taxpayers Foundation predicts savings are “certain” to exceed the $100 million per year estimate frequently mentioned by proponents of the law prior to its passage last year.

Only four communities — Brockton, Easton, Kingston and West Springfield — have voted against adopting the reform law, while 94 municipalities and school districts have voted to adopt it.

The law was approved last year after tense deliberations over its impact on collective bargaining. The final law, intended to secure savings in part by shifting new costs to employees, included provisions that allow employees to share in any savings. The update estimates that employees in communities where health plan changes are being made will save $35 million of the roughly $80 million in savings through premium reductions or “mitigation plans.”

The report says 50 municipalities and school districts have reached agreements to make health plan changes, saving $50 million, without needing to turn to an outside review panel authorized under the reform law.

The estimated savings include $30 million not directly linked to the law but achieved by a dozen communities through collective bargaining changes made between January 2011 and July 2011, when the law was signed.

Those communities include Boston, Lynn, and Medford.

Other findings: 19 communities are in negotiations and expected to finalize agreements with employees within 30 days; 32 cities, towns and school districts have adopted the reform law but not begun negotiations; and 14 more communities or school districts have scheduled votes on adopting the law.