Keep this experiment going

BECAUSE of the state's bold experiment in broadening health coverage, Massachusetts now has the highest rate of insured residents in the country - 94.6 percent, according to recent census data. But the cost of progress has risen, as more and more of the uninsured sign up for the state's subsidized Commonwealth Care plan. Once estimated at $472 million in its first year, the bill came in at $630 million.

Even so, Massachusetts must keep this experiment going. Today, a state agency will hold a hearing on a sensible proposal by the Patrick administration to close the gap - it wants to collect from more businesses that are not doing a good job of providing insurance for their employees.

Under the plan's original design, a firm with 11 employees or more would have to pay the state a modest $295 a year for each uninsured worker if the company does not insure 25 percent of its full-time employees or provide 33 percent of its workers' premiums. The Patrick administration wants to change that so that companies can escape the $295 fee only if they insure 25 percent of their workforce and provide 33 percent of premiums.

With this tougher standard, it is estimated that revenue from the penalty fee will jump from $7.4 million this year to more than $40 million.

Employers are not the only stakeholders in the healthcare reform plan who will have to give more than first expected under the administration's adjustments. In April, those insured by Commonwealth Care had to swallow a 10 percent increase in premiums, and higher copays as well. The Legislature has increased the assessment on hospitals by $20 million, and took $38 million from insurance companies with excess reserves. The state itself is also kicking in $35 million from a health fund for the unemployed that is running a surplus.

All of this will ensure that the state does not have to close off enrollment in Commonwealth Care, a step that would strike at the heart of the landmark Massachusetts law. The plan has broken new ground by mandating that individuals must get insurance in one way or another. Results are so encouraging that it recently won praise even from Mitt Romney, who helped design it when he was governor but has blown hot and cold over it since.

But it would be impossible for the state to mandate insurance if it could not provide subsidized coverage to all who are eligible. Collecting from more businesses that are not doing enough to provide coverage to their workers is a good way to keep the state's promise of universal coverage alive.