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.
Might be a good way to get the mooches out of the neighborhood.
In my medical career of 25 years, the number of deadbeats (who refuse to pay) is up about 10X, from around 2% to around 20%.
The number who are really, really unhappy about paying is also up sharply. The Democrats have done their work well, and the gospel of "free care" has become very widespread.
There is no short-term solution to this problem.
The funniest twist on this story is in Travel Clinic, where overseas travelers come for shots and other health promotion advice. About 10% walk out when they find out they have to pay.
Someone who will spend $25 000 on a trip won't spend $50 on preventative medicine.
Hillarycare is in everyone's future - it's just a matter of time.
You, like so many others on this thread do not see the bill for what it is but rather are focusing on only one aspect. That is the provision for a minimum level of insurance paid by the individual. The bill's intent, as it was discussed in the local media for several years, is to promote responsible behavior by those who by all accounts are rich and do not presently buy insurance. It is also a tool used to establish identity with respect to the tax law when one seeks treatment. There is a huge underground economy in Massachusetts and there is a growing demand for health care for those who have no insurance. Something is wrong, and this apparently is an attempt to fix it.
The increased cost of health care isn't based upon those who refuse to pay. That's rhetoric. It's based on lawyers, law suits, and those who want to get rich of the system. Truly horrible things can happen to innocent victims, but exhorbitant awards are creating havoc on our health care.
I don't go to the doctor because I'm sick of waiting in the waiting room for an hour while people take their infants in for the fouth time this month for amoxicillan for continued ear infections or the like. When the baby still cries and the mom comes back for the fifth time, surgery is scheduled to insert drains. Some people will badger a doctor until something is done...even if that somthing isn't helpful because they think they have some kind of in-born right for illness not to happen to them.
I'm fed up. We get sick, we die. Sometimes there's nothing we or anyone else can do about it. I am not willing to pay for people's free ride anymore...I'm just not!
You peons will want what we TELL you to want!!!
Sounds like liberal coercion. I recall when Massachusetts was proud of its freedom. Today it is held hostage by socialism and heavy taxes.
I understand that..but moneys in HSA's can sometimes be used to purchase health insurance. I think that HSA's are a useful vehicle for tax free savings, but most Americans could never put away enough money in these accounts to cover major medical bills. A simple biopsy can run a couple thou.
Many medical providers have built into their charges the fact that many will not pay or will underpay for the services. Everybody else has to pick up the bill. I do know that providers will discount a service if cash is paid though.
It's a mess.
I never wrote that the increased or increasing costs of healthcare is because of those who refuse to pay. I believe that I implied or stated that your costs increase when there are those who refuse to pay. That is to say, if they paid their share,yours would be less.
Overall. I agree, health care costs are a sum of all of the costs associated with a complex industry. Lawyers are a part of it but so are the fact that you and I are dealing with a difficult customer base, sick people.
>>>> but most Americans could never put away enough money in these accounts to cover major medical bills.
It is a mess. Because we don't need to be penalized for other people's care.
Or people that think their sick.
You probably missed my post about raising five children without insurance. My husband and I own our own business. When it was starting out, there is no way we could afford insurance or health care. What did we do? We bartered with doctors several times, we set up payment plans and we didn't go to the doctor for every little sneeze, sniffle, ache and pain. We had children at home with a mid-wife.'
And before you say that was then... my youngest just turned 18. Now we have 15 employees, we offer health insurance because we want to, it isnt required nor is it customary for a business this size or in our construction industry. Not many of them appreciate it, they think it is owed to them, in fact some of our worst employees have the gall to ask for more.
We have a couple of employees who opt out and take the money. They have private plans with more options. They are good concientious workers who always offer to do the difficult work and work the most hours. I struggled for 20 years and I'm stronger for it, but it doesn't stop my disgust with some people with their hands out to the government.
In fact, I have an employee that will not accept a raise even though we've offered him one once a year. He'll lose his government benefits. He's making $10.00 per hour, the rest of our employees make between $15 and $24. His government benefits are worth that much to him.
this clearly isn't going to go over well on FR or with the GOP base. But it's probably going to look pretty good to a lot of voters who aren't as ideological. Health care is a major concern in this country, and people are looking for answers. This may hurt him in the primaries, but should he get over that hurdle, it's something he would be able to point to in the general election.
Not that I'm saying this is a good policy idea, just observing that it will play well with a lot of people.
If Mass is losing population it is either because the universities are downsizing or the "massholes" are moving to NH. NH is becomming very scary.
I know my brother, and although he carries 0 in health insurance he is one big time Republican conservative. Yes, he goes on the trips, as cheap as he is, he is one of those who thinks he is smarter than everyone else, (he has a point), and he is investing whatever he would sink into health insurance into stocks and bonds I am sure.
Although he has reached that 40 mark he considers himself way younger (think 29). Have you seen this syndrome? The I will never get old so I don't need health insurance syndrome?
I don't have any strong impressions about who has or doesn't have health insurance.
I do carry the full boatload of health insurance, even though, I'll never need it or get old! :)
Bull's-eye.
$295 is just the initial tax, er, I mean "fee" which they kept low to avoid a firestorm in the beginning. I can just imagine what it'll be in few years.
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