NY Times Lead Editorial: The Massachusetts Way

Today’s lead editorial in the New York Times:

The Massachusetts Way

The pioneering Massachusetts program to provide health insurance for all citizens looks more and more successful with each passing month.

The number of uninsured has dropped — Massachusetts now has the lowest rate in the nation — and so have the number of those who turn to costly emergency rooms for routine care. And while the state has had to seek additional sources of revenue — mainly because of the program’s popularity — the gains in the first 21 months suggest that the plan could become a model for universal health coverage for other states or the nation.

Massachusetts enacted its ambitious health insurance reform two years ago under bipartisan leadership from then-Gov. Mitt Romney and a Democratic Legislature. Although Mr. Romney distanced himself from the plan during the Republican primaries, he was back to extolling its virtues in an opinion piece for The Wall Street Journal last month.

The plan requires everyone to take out health insurance or suffer a tax penalty and requires employers to offer coverage or pay a small assessment if they don’t. Low-income residents can enroll in an expanded state-federal Medicaid program or receive subsidies to pay all or part of the premiums for private insurance. Those who earn more than 300 percent of the federal poverty level (about $63,000 for a family of four) receive no subsidy but can buy private policies through a new insurance exchange at much lower rates than before.

More than 439,000 people have taken out coverage since the program began in mid-2006 — two-thirds of the estimated 650,000 who lacked health insurance when the program began.

More than 40 percent of the newly insured purchased private commercial policies without any government subsidies, defying dire predictions that employers would drop their plans and a horde of individuals would drop private policies. What seems to be happening instead is that workers who previously shunned their employers’ plans have decided to sign up now that insurance is required.

The big expansion in coverage has yielded a commensurate drop in the number of “free riders,” those who use hospital emergency rooms and community health centers for routine care that they don’t pay for. The cost of that uncompensated care dropped from $166 million in the first quarter of fiscal 2007 to $98 million in the first quarter of 2008.

Far more people have enrolled far more quickly than expected, driving up the total budget for subsidized care beyond Medicaid to $869 million in the next fiscal year, about half of which will be absorbed by the state and the other half by redirected federal funds. The cost per person is actually less than expected. The program to date is fully financed.

That may still look like a lot of money, but universal coverage is vitally important to enhance the health of previously uninsured citizens. In the long run, full coverage should serve as a springboard toward reforming the health care system to deliver higher quality, more cost-effective care.

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4 Responses to NY Times Lead Editorial: The Massachusetts Way

  1. PJ says:

    …and a big problem is that small businesses are unable to negotiate more reasonable rates. Their rates are calculated based on the ages of their employees. The premium at my former job, a small business, was $425 per month for an HMO ($500 inpatient copay, $250 op surgery, $20 office visits).
    In contrast, a close family member of mine works for a large corporation. He chose the most expensive of the three plans offered by this firm. It is a BC/BS PPO with $10 office visits, $0 copay for inpatient services or op surgery. Total premium for this plan: $330 per month.
    I’ll agree that “At least this is a start” when individuals, small businesses, and large corporations are all on level playing ground.
    Oh, and when they investigate some of these “needy” Commonwealth Care enrollees who are stealing MY tax dollars. (see examples from some of my previous posts and also this blog’s “foreigner of the week” spotlight or whatever they call it – where a new herd of immigrants gets signed up for subsidized care and they instantly have all kinds of costly health problems that need attention)

  2. Katelyn says:

    Definitely a move in the right direction. Hope the nation will soon follow suit and take into consideration lessons learned and challenges faced in MA!

  3. At least this is a start. It’s not perfect, by any means but at least the machine is starting – starting to change!

    “What seems to be happening instead is that workers who previously shunned their employers’ plans have decided to sign up now that insurance is required.”

    This is SO true…

  4. ? says:

    “The plan requires everyone to take out health insurance or suffer a tax penalty…”?

    NY TImes Editor,

    What’s the tax penalty for a non-filer in a non-tax year?

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