Posted on 04/05/2006 7:05:04 AM PDT by CSM
Tuesday, April 4, 2006 10:54 p.m. EDT Romney to Sign Mandatory Health Bill
BOSTON -- Lawmakers overwhelmingly approved a bill Tuesday that would make Massachusetts the first state to require that all its citizens have some form of health insurance.
The plan — approved just 24 hours after the final details were released — would use a combination of financial incentives and penalties to dramatically expand access to health care over the next three years and extend coverage to the state's estimated 500,000 uninsured.
If all goes as planned, poor people will be offered free or heavily subsidized coverage; those who can afford insurance but refuse to get it will face increasing tax penalties until they obtain coverage; and those already insured will see a modest drop in their premiums.
The measure does not call for new taxes but would require businesses that do not offer insurance to pay a $295 annual fee per employee.
The cost was put at $316 million in the first year, and more than a $1 billion by the third year, with much of that money coming from federal reimbursements and existing state spending, officials said.
The House approved the bill on a 154-2 vote. The Senate endorsed it 37-0.
A final procedural vote is needed in both chambers of the Democratic-controlled legislature before the bill can head to the desk of Gov. Mitt Romney, a potential Republican candidate for president in 2008. Romney spokesman Eric Fehrnstrom said the governor would sign the bill but would make some changes that wouldn't "affect the main purpose of the bill."
Legislators praised the effort.
"It's only fitting that Massachusetts would set forward and produce the most comprehensive, all-encompassing health care reform bill in the country," said House Speaker Salvatore DiMasi, a Democrat. "Do we know whether this is perfect or not? No, because it's never been done before."
The only other state to come close to the Massachusetts plan is Maine, which passed a law in 2003 to dramatically expand health care. That plan relies largely on voluntary compliance.
"What Massachusetts is doing, who they are covering, how they're crafting it, especially the individual requirement, that's all unique," said Laura Tobler, a health policy analyst for the National Conference of State Legislatures.
The plan hinges in part on two key sections: the $295-per-employee business assessment and a so-called "individual mandate," requiring every citizen who can afford it to obtain health insurance or face increasing tax penalties.
Liberals typically support employer mandates, while conservatives generally back individual responsibility.
"The novelty of what's happened in this building is that instead of saying, `Let's do neither,' leaders are saying, `Let's do both,'" said John McDonough of Health Care for All. "This will have a ripple effect across the country."
The state's poorest — single adults making $9,500 or less a year — will have access to health coverage with no premiums or deductibles.
Those living at up to 300 percent of the federal poverty level, or about $48,000 for a family of three, will be able to get health coverage on a sliding scale, also with no deductibles.
The vast majority of Massachusetts residents who are already insured could see a modest easing of their premiums.
Individuals deemed able but unwilling to purchase health care could face fines of more than $1,000 a year by the state if they don't get insurance.
Romney pushed vigorously for the individual mandate and called the legislation "something historic, truly landmark, a once-in-a-generation opportunity."
One goal of the bill is to protect $385 million pledged by the federal government over each of the next two years if the state can show it is on a path to reducing its number of uninsured.
The U.S. Department of Health and Human Services has threatened to withhold the money if the state does not have a plan up and running by July 1.
No. But a better idea would be having two treatment options, one with the right to sue (high prices and unneccessary tests, and doctors focused on documenting their work instead of treating the patient) and one without the right to sue (doctors focused on one goal, the health of the patient).
I can afford the best health care out of my pocket. I can't stand the endless useless procedures and the endless paperwork the doctors put me through to cover their rears.
They are now carryover and no longer "use or lose" systems. In addition, my deductibles can be set up to mirror what is in my account and the monthly rate is adjusted accordingly. I am just starting to use this type of coverage so I don't have any experience to judge, but I anticipate being very satisfied with the flexibility.
and that is?
BULL. Clinton dramatically cut the military because the cold war was over. Clinton and his wife wanted to bring you a much more burdensome healthcare plan than this one. Clinton was dragged kicking and screaming into welfare reform by the republican congress. Bush's medicare drug program is really bad, but in that same bill are health savings accounts which is really good and is the first step to real health care reform.
No, he probably saves a lot in the short run, so long as he's healthy. But if he contracts cancer or falls off a ladder, he's really screwed. Insurance is a waste of money if you're always healthy, unfortunately that's not something we can count on.
This conjecture is based upon the presumption that increasing the pool of insured will spread the risk. Unfortunately, as with ALL governmental meddling with the free market, there are unintended consequences. In this case, it is pretty easy to predict. Instead, they are forcing a wider collection of people to participate in the medical insurance system which will induce a larger proportion of the population to acquire limited medical services. The results will be longer lines, more delays, and higher costs for those currently participating. Back in the 1960's my father predicted the ultimate failure of the U.S. medical system. He pointed out that a system where insurance companies collect premiums for potentially unlimited services delivered by a third party was a system with no "feedback" control. The managed care programs have attempted to reign in the costs by having the insurer employ the doctor directly and stipulate precise protocols for service delivery. People blanch at having the insurers dictate the level of service and uncontrolled programs, such as Medicare, pump clients into the medical system which still causes prices to rise.
My father suggested, in the 1960's, that if government wanted to meddle in order to control health care costs, they should BAN all medical insurance programs. I believe that health care would improve if all, but catastrophic coverage, were eliminated. I do like the idea of health savings accounts which allow people to shelter health care costs from taxes. [I'd also like such an account for my food and housing and cars and ... ;-) ]
Think carefully, I'd hate to go in for stones and wake up with a sex change.
The current system is called medicaid and yes you are paying for that.
I'm sure that Hillary is darned proud of Willard Mitt.
A potential running mate?
"In the good old days" most died before the age of 50.
What's the punishment? Do they take away your health?
He can kiss his presidential ass-pirations goodbye!
Yes I mean no subsidies for the poor unless they really have something wrong like missing legs or brains that are not functioning according to a mri and not a psychologist's opinion.
On the west side of columbus, a church burned down without fire insurance.
People are contributing and so far they have raise about 20k which is about 200k short of what they need.
If you can't afford 40k out of your pocket, you need to have insurance.
Yeah...sure, fee's aren't taxes.
Question: Do they really think we are stupid?
Answer: We sure act like we are....
Well, there goes his presidential aspirations.
"The problem is that the uninsured do cost everybody in the form of increases in our premiums."
All insurance schemes are Ponzi scams made legal; not one person insured who lives a full life will pay in more than is spent out before his death unless he dies where no busybody or concerned relative dumps him on the system we've created. Inflation guarantees this and a plan such as this one to make the covered group inclusive only adds to the inflation.
I'm thinking there may be a few out there who can't.
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