As President Obama signed historic health care legislation Tuesday, local health care professionals combed through the bill to determine its impact on the state.

As President Obama signed historic health care legislation Tuesday, local health care professionals combed through the bill to determine its impact on the state.


"I think the devil's in the details as they say, and we're anxious to see the details," said Edward Kelly, president of Milford Regional Medical Center.


At their core, the bill and a separate but related proposal awaiting Senate approval will expand insurance coverage to 32 million additional Americans. Massachusetts passed similar reform in 2006, leaving business owners, medical providers and health advocates scrambling to reconcile the two.


"I think that's the biggest question," said Martin Cohen, president and CEO of MetroWest Community Health Care Foundation. "The good news is it brings the rest of the country up to where Massachusetts is."


Like the new national bill, state law requires residents to carry insurance or face a penalty. But the federal legislation expands the income limits for subsidies, and also immediately adds additional time for children to remain on their parents' plans, with a cutoff at age 26.


While two national provisions are already in place in Massachusetts or are not a problem insurers can't discriminate against pre-existing conditions and don't usually drop sick customers the new ban on capping lifetime benefits could help.


Plans in the state are not allowed to cap core services like doctor visits and drug coverage but do limit some other benefits, said Brian Rosman, research director at Health Care for All in Boston, one of the groups analyzing the new federal law.


"Everyone's scrambling today," he said. "This is complicated stuff."


On first pass, Rosman said, it appears that employer requirements from both the state and national laws could be enforced simultaneously unless the Massachusetts Legislature acts.


Under existing state law, firms with 11 or more employees must provide insurance or pay a penalty.


Under the bill Obama signed, companies with 50 or more workers will get fined starting in 2014 if any of their employees receive a federal subsidy to buy insurance because they can't get it through work. But companies with fewer than 25 employees would also receive tax credits to provide coverage.


At the MetroWest Chamber of Commerce, new President and CEO Bonnie Biocchi said it was too early to judge how state firms might be affected, with mixed reviews from members and a combination of hope and trepidation.


"We're just watching it very closely right now," she said.


Under the national plan, medical device makers like Boston Scientific of Natick will face a new 2.3 percent tax but will likely enjoy an expanded customer base. The bill also includes tax credits for life science firms and extended patent protections, benefiting companies like Genzyme.


To pay for the plan, individuals making more than $200,000 and couples earning more than $250,000 will be assessed new federal taxes. Those with the most-costly insurance plans will also get hit - a small portion of residents.


While payments to private Medicare Advantage plans will get cut, the new bill closes a gap in regular Medicare prescription drug coverage known as the "doughnut hole."


And though national hospital associations have agreed to $155 billion in Medicare, Medicaid and other cuts, a reduction likely to reach local hospitals, the federal government has also promised Massachusetts $2 billion in additional Medicaid aid over a decade.


"I think it's for a good cause," MetroWest Medical Center CEO Andrei Soran said, describing how some patients had run into coverage caps and had a hard time paying bills. "We'll do our share."


While Kelly is concerned about a loss of payments, he called the goal of increasing the insured a noble one.


"Everyone has to do their part to make this work," he said.


For additional answers about how federal reform will affect residents and businesses, call the state's Commonwealth Connector at 617-933-3140.


MetroWest Daily News writer Michael Morton can be reached at mmorton@cnc.com or 508-626-4338.