The Legislature seems likely this session to seriously discuss the need to reform municipal health insurance, with proposals from Gov. Deval Patrick, the Massachusetts Municipal Association, and, at last count, more than two dozen additional municipal health insurance reform bills before the Public Service Committee.

The Massachusetts Taxpayers Foundation weighed in first in February with a report outlining the prospective cost of municipal health insurance for 50 communities.

Just this week, the Boston Foundation and the Massachusetts Taxpayers Foundation collaborated on an additional report that compares the health care benefits offered to municipal employees with those offered to workers in the private sector and to state and federal employees. It provides further evidence that municipal health care benefits are unsustainable and that municipalities need the authority to manage their costs.

DLS data shows that municipal health insurance costs for the Commonwealth's 351 cities and towns rose from $1.411 billion in FY04 to $2.049 billion in FY09, an increase of 45.2 percent. The data breaks it down for individual communities as well, for the purpose of comparison.

The bullet halfway down the DLS webpage titled, "Retiree Health Insurance Cost Shift Local Acceptance," shows that 271 cities and towns have already moved their eligible retirees to Medicare, which is one of the most basic reform recommendations.

The Governor's plan would allow for communities to negotiate with municipal unions, but would also require that the end result of the negotiation produce a health insurance plan no more expensive than that offered by the Group Insurance Commission.

There is no doubt that cities and towns need relief from the overwhelming burden of employee health insurance costs. That said, the question begs to be asked; should the Legislature act, in which direction will they move and what will "relief" look like when it lands on the Governor's desk.

Robert G. Nunes