DON'T BE fooled by the national press coverage suggesting the Massachusetts health plan is in trouble. The plan is suffering from a bit too much success, but the state has the resources to pay for it this year and next.
Enrollment in Commonwealth Care, the subsidized insurance offering, is higher than anticipated, but Governor Patrick and the Legislature are ready to pay the extra costs this year. In the fiscal year that begins this July, the governor has budgeted $869 million for Commonwealth Care, but over half that increase will be defrayed by the federal government. Rising costs are inevitable as the plan is rolled out.
Barring a financial collapse, the state will have the money to pay for the health initiative through fiscal 2009. In case more is needed, House Speaker Salvatore DiMasi and Senate President Therese Murray are talking about a cigarette tax increase. The Legislature will not let this initiative fail for want of money.
The state needs continued federal support for the plan. To seek this aid, it has to make three-year cost estimates. Much is uncertain about healthcare economics over the next few years, so it is wise not to panic about imprecise forecasts - in this case a $1.35 billion cost in 2011. Instead, providers, insurers, consumers, businesses, labor, and the government need to unite around a campaign to control costs.
Even though Massachusetts is a high-cost state, buffeted by competitors on all sides, and dependent on federal policies it cannot control, its elected representatives resolved to do what no state has ever attempted: require everyone (with hardship exemptions) to get health insurance and provide the means for most of them to afford it.
In a little less than two years, here's what Massachusetts has achieved:
Governor Arnold Schwarzenegger's plan to do something similar died in a California Senate committee recently. In Massachusetts, the coalition behind the health reform law is holding firm. The plan itself is creative and sound. Who dares call this a failure?![]()


