Mass Health Care: Massachusetts Goes Universal

How many people are uninsured in your state? What do you want your state representatives to do about it? What is your experience with health insurance as an individual, family, employer, or uninsured person?

Massachusetts has stunned the healthcare industry and Capitol Hill with a groundbreaking bill that promises health insurance to nearly every Massachusetts resident by 2007.

The legislation was a truly bipartisan effort, with support among state and federal lawmakers.

The bill is a combination of Republican and Democratic proposals and therefore satisfies both parties’ philosophies of health care.

Collaborating philosophies

The Democratic philosophy of health care empasizes that all Americans are entitled to health care. They believe that government should provide health coverage to the less fortunate.

The Republicans’ philosophy emphasizes that health care should be largely separate from the government. They favor a free-market approach in which private competition, not public funds, works to increase quality and lower costs. Further, Republicans believe in individual accountability -- individuals should be responsible for their health and make good use of their resources.

The Massachusetts near-universal health care proposal would incorporate both of these philosophies by expanding the government’s role and individual responsibility.

The bill requires every Massachusetts resident who can afford it to buy health coverage or else pay income tax penalties. The penalty money would then be used to help lower-income workers to afford health care. The government would subsidize premiums for people who earn up to 300 percent of the poverty level ($60,000 for a family of four) and provide free health care to those below the federal poverty line ($20,000 for a family of four).

Further, the legislation helps small businesses and the self-employed afford health care by allowing them to buy insurance with pre-tax dollars.

Nagging questions

Although politicians and health care advocates are celebrating the bipartisan agreement, many are wondering how and if insurance firms will supply the type of affordable health insurance demanded by the legislation. Legislators estimate "affordable" to mean around $250 a month for an individual as compared with the average $600 per month that individuals currently pay.

Policy experts say that to lower health care costs, Massachusetts may have to re-evaluate its mandates for insurance-covered services. For example, Massachusetts now requires coverage for expensive fertility treatments, but changing the law to make it an optional benefit may keep down basic policy costs.

The legislation does attempt to lower costs through insurance plans with high deductibles that are designed specially for residents 19 to 26 years old. Young adults make up over 20 percent of the state’s uninsured, so by requiring this healthy group to contribute, the bill expands the pool from which all can draw benefit.

Another question is: How will Massachusetts keep employers from dropping benefits? Employers who do not contribute to employee premiums would have to pay a penalty of $295 per worker per year, but many say this is not enough to deter employers.

Massachusetts’ new health care system will be a grand experiment from which other states can learn. New questions and issues will surely arise from this bold and daring piece of legislation.

Americans in favor of universal care

Many Americans are in favor of a universal healthcare system. However, economists remind us that healthcare industry prices inflate at a much faster rate than other markets, regardless of competition. The high cost of health care makes it difficult for states to devise health care systems that will cover us all. And it’s not just about cost anyway. What about quality?

WomenMatter continues to raise the question: "What’s the question?" Is it how to get quality or how to hold down costs? How do Americans wish to share the risk of getting sick?

Which of these is your priority? Quality or cost? Are you willing to share the risk with people who may be sicker and older than you in order to get both quality and cost?

Your input matters

Your representatives DO care what you think. Especially now -- 2006 is an election year and many representatives will be looking to reconnect with their constituents. Let your congressmen and women know what you think! Give your senators a piece of your mind! To find your reps, click here.

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Posted on: 4/14/2006