MIT economist and Connector Board members Jonathan Gruber uses the Massachusetts experience to provide two smart, analytic defenses of health reform. Both columns appeared on the Citizen Cohn blog at The New Republic.
In A Health Reform Critic Flunks Math, Gruber takes on the miscalculations of Tennessee Governor Phil Bredesen. Breseden published an article in the Wall Street Journal last week claiming that under health reform it would make financial sense for Tennessee and other employers to drop coverage and let their workers get federally-subsidized coverage through the Exchange.
Gruber finds the holes in Bredesen’s faulty math (most workers wouldn’t get much or any subsidies, among other issues), but also points to the Massachusetts experience as a valid comparison. Employer coverage soared in Massachusetts following health reform, and more employers began offering coverage. Rather than erode coverage, the combination of employer fair share requirements, individual mandates, and sliding scale subsidies shores up the employer coverage system at a time when its in steep decline.
Gruber’s second post defends the individual mandate by comparing Massachusetts to Vermont. While both states have subsidies to help low and moderate-income families afford coverage, only Massachusetts includes a mandate to have coverage. Gruber shows that Massachusetts has a much lower uninsurance rate, and coverage is more comprehensive for roughly the same premium.
With Massachusetts years ahead of national reform, we provide a true laboratory to see how health reform works, and what are the pitfalls. In the four years since chapter 58 was enacted, the state and the Connector have made numerous adjustments along the way, learning from experience. It’s good that we can share that experience with other states, and the national policymakers. This could be the most significant legacy of Massachusetts health reform.