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Support for state health law rises

Residents split on coverage mandate

By Kay Lazar
Globe Staff / June 5, 2011

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Support for the Massachusetts universal health care law has increased since 2009, according to a poll of the state’s residents — even as the law has become the subject of blistering attacks in national and presidential politics, and health care costs soar.

The poll by the Harvard School of Public Health and The Boston Globe found that 63 percent of Massachusetts residents support the 2006 health law, up 10 percentage points in the past two years. Just 21 percent said they were against the law.

Yet opposition has grown to one of its central elements — the requirement that people who can afford insurance buy it or face a fine. A similar provision in the national health care overhaul passed last year has been the subject of a contentious legal fight.

Forty-four percent said they oppose the mandate in the Massachusetts law, compared with 35 percent who opposed it in a 2008 poll. Still, the mandate retains the support of a narrow 51 percent majority of residents.

Percolating throughout the findings is a growing anxiety about health care costs, which are higher in Massachusetts than in the nation as a whole.

Residents are split on whether Mas sachusetts can afford to continue with the law as it stands, and 30 percent said the law is hurting the cost of their care, up from 22 percent in 2009. Yet when asked about the law’s role in boosting health costs in Massachusetts, 72 percent said rising costs were mainly because of factors other than the law.

The majority’s perception — which aligns with health policy specialists’ view that overall medical inflation is driving up costs in Massachusetts — may help explain the continued strong support for the law.

“I was quite surprised,’’ said poll co-director Robert J. Blendon, professor of health policy and political analysis at the Harvard School of Public Health. “Nationally there are so many critics blaming costs on the Massachusetts law, I thought maybe residents would be picking up the rhetoric.’’

Blendon said support for the law may have increased along with the economy — it’s now about the same as it was before the recession — and because “it’s established. It’s running. It hasn’t caused problems for people.’’

Fewer than one in five said in the poll that the law is hurting their quality of care, their ability to pay medical bills if they get sick, or the time it takes to get an appointment with a physician.

The telephone poll of 537 Massachusetts adults, conducted from May 24 to 26 in English and Spanish, has a margin of error of 5.3 percentage points.

The findings have implications beyond Massachusetts, particularly for the presidential campaign of Republican Mitt Romney, an architect of the Massachusetts plan who signed it into law when he was governor.

Massachusetts’ law was used as a blueprint for the national legislation passed by Congress last year, fueling withering criticism of the law from conservatives who say Romney’s plan is too similar to the one President Obama spearheaded for the nation.

But Blendon said the poll results could provide cover for Romney: “You can’t say he’s the parent of a disaster,’’ he said.

Romney has said he stands by the Massachusetts law as a “state solution for a state problem,’’ but believes it should not have been used as a model for the nation.

Many state residents apparently agree. While there is wide support for the law in the state, residents are nearly evenly divided on whether it should have been used as a national model, with 47 percent saying it should not have been, and 43 percent saying it should have.

Those findings run strongly along party lines, with Republicans and independents at least twice as likely as Democrats to say it should not have been used as a model.

Still, more Massachusetts residents support the national law than oppose it. They appear to be more favorable toward the federal legislation than people nationwide who were asked the question the same way in a March AP-GfK Poll — 40 percent vs. 35 percent.

Health policy specialists say the Massachusetts poll results may bode well for Obama, who has pointed to the state’s experience as a bellwether for the nation.

“When you see the benefits of health reform in place, in the one place in the nation where we have it, people are reacting much more positively than negatively,’’ said Drew Altman, chief executive of the Kaiser Family Foundation, a California-based policy organization.

For Ann Weiss, a 60-year-old high school English teacher from Hanson, the Massachusetts law has been promising and problematic. Weiss, a Republican who took part in the poll and agreed to answer follow-up questions, said the state law has helped her family, allowing her to keep her daughter on her insurance plan until she was 26 — a provision that is now echoed in the national law.

“It used to be that the day they graduated college they were off insurance and that was a terrible worry,’’ Weiss said.

Weiss favors keeping the Massachusetts law, but with some notable changes, namely getting rid of the provision that requires most people to buy insurance.

“If people want to not have health insurance, it’s up to them, but I also feel it should be available at a reasonable cost,’’ she said.

Judy Cooper, a 66-year-old Democrat who lives in Lexington, believes that the rising cost of insurance has undermined the law’s success. Cooper, a semiretired educational publishing editor, is on Medicare now, but had to buy her own insurance for a brief time a couple of years ago and found the price nearly prohibitive.

Still, she describes herself as a strong supporter of the law because it expanded coverage to many who could not afford it. “I think it’s immoral to leave people to die or to be sick because they don’t have money,’’ she said.

The poll results show that residents with incomes below $30,000 — the bracket that would probably make them eligible for state-subsidized care — were the most likely to say the law is helping to control the cost of their care.

The law expanded eligibility for subsidized coverage to thousands more residents, and state figures a year after the law went into effect showed that more than 200,000 residents were added to state-run coverage.

The poll results also showed that the highest income group, those whose income exceeds $75,000, were more likely than the lowest income group to say the law is hurting their health costs.

Kay Lazar can be reached at klazar@globe.com.

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