Attorney General Coakley files Supreme Court brief supporting federal health law

By Chelsea Conaboy, Globe Staff

Attorney General Martha Coakley filed a brief with the U.S. Supreme Court today arguing that the state’s experience since passage of the 2006 health law validates the federal law.

The court is scheduled to hear oral arguments starting March 26 in a case challenging the constitutionality of the federal law’s requirement that most Americans buy health insurance.

“Massachusetts is uniquely situated to speak to the actual economic effects of comprehensive reform that includes an individual coverage requirement,” the brief says.

Blue Cross Blue Shield of Massachusetts, the state’s largest insurer, also submitted a brief laying out a similar argument in favor of the national law and calling the coverage requirement “essential” to Massachusetts’s health care system.

The attorney general’s brief cites former Governor Mitt Romney’s role in getting the law passed, saying that he filed the bill that started the process in July 2005 with a letter that read in part, “With Safety Net Care in place, it is fair to ask all residents to purchase health insurance or have the means to pay for their own care. This personal responsibility principle means that individuals should not expect society to pay for their medical costs if they forego affordable health insurance options.”

As a candidate for the Republican presidential nomination, Romney has said repeatedly that he would repeal the federal health law.

The brief goes on to say that the assumptions made in passing the state law have been borne out: Requiring most residents to have health insurance has increased enrollment in health plans and decreased the burden on the state to pay for the care of the uninsured.

Coakley writes:

The experience in Massachusetts elevates the connection between eliminating free-riders and controlling costs from a rational belief to a demonstrable correlation. Governor Romney and the Massachusetts Legislature, like Congress, determined that an individual health insurance mandate, as part of a comprehensive reform package, would serve to increase access to healthcare while greatly decreasing the detrimental cost-shifting caused by people who chose to forego insurance and shift the cost of their current and future healthcare to others. As discussed above, in the four years after Chapter 58’s enactment, there was, indeed, a significant increase in the percentage of insured Massachusetts residents. The significant gains in the number of Massachusetts residents with health insurance helped spur a corresponding sharp decline in the amount of spending on “free care” for the uninsured and under-insured: The amount of free care dropped 33 percent -- hundreds of millions of dollars -- from fiscal year 2006 to fiscal year 2010.

The brief also states that the federal law is necessary to make changes in health care that single states can’t do alone. In fiscal year 2009, Massachusetts hospitals cared for more than 43,000 out-of-staters at a cost of about $910 million. About 1,200 of those had no insurance, the brief says. The federal law also allows for the government to institute minimum coverage standards for large employer-based plans over which the state has no regulatory control.

Massachusetts is not a party in the case, in which officials from 26 other states have opposed the individual mandate.