BOSTON --With the end of the year fast approaching, uninsured Massachusetts residents are scrambling to sign up for health care plans and avoid being among the first to face tax penalties for failing to get insurance before Dec. 31.
It's a deadline with practical and political implications.
For the still-uninsured, failure to meet the deadline could translate into a loss of their personal exemption when they file their 2007 state income tax returns in April -- a $219 hit.
For Mitt Romney the political hit could be far bigger.
The specter of residents in his home state being penalized for not obtaining health insurance could present a risky political backdrop for the former governor and Republican presidential hopeful just as the primary season enters its homestretch.
It plays into the hands of Romney's political foes who have tried to paint Massachusetts' landmark health care reform law -- which Romney helped shepherd through the Statehouse and signed at a ceremony at historic Faneuil Hall -- as a big government mandate.
"It could boiled down by his opponents that Mitt Romney passed some big government program and now people are being penalized for it," said Julian Zelizer, professor of history and public affairs at Princeton University. "It gets to the question of whether Romney is a true conservative."
Adding to the potential criticism is Romney's support for the so-called "individual mandate," -- the requirement that individuals, and not the government, take responsibility for their own insurance.
Under the law, the state provides virtually free care for those making less than the federal poverty and subsidized care for those earning up to three times the poverty level. The state also worked with private insurers to come up with lower cost health plans for those not qualified for subsidized plans.
Romney touted the law as a signature accomplishment of his time as governor. On the campaign trail he's walked a finer line.
He criticized a plan floated by Democratic candidate Hillary Rodham Clinton as "Washington-managed health care" even though it shares the same individual mandate included in Massachusetts' law.
Under the Massachusetts law signed by Romney, the penalties for the uninsured increase significantly in the second year and accrue for each month someone does not have insurance.
Romney spokesman Eric Fehrnstrom said the individual mandate in Massachusetts' law guarantees "no more free riding."
"In a reformed marketplace, where the price of private market policies have been lowered and we subsidize the purchase of insurance by people who need help, it is irresponsible to expect taxpayers to pay for your health care," Fehrnstrom said.
The subtleties of the law could get lost if Massachusetts decides to crack down on scofflaws just as Romney is trying to gain ground in early primary states, Zelizer said.
"That's going to be a problem for him when all the other Republicans are gunning for him," he said.
Health officials in Massachusetts are hoping that renewed efforts to educate people about the law may keep down the number of those who facing the tax penalty.
Jon Kingsdale, executive director of the Health Insurance Connector Authority, which oversees the health care law, said that to guarantee they have insurance by Dec. 31, anyone still uninsured should sign up by Nov. 15.
Kingsdale is making a special appeal to younger adults, who may feel they don't need insurance.
"Perhaps you're young and feeling quite invincible," he said in a recent column. "Those who remain uninsured are only a diagnosis or an accident away from incurring tens of thousands of dollars in medical expenses, a self-imposed penalty far worse than $219."
The connector authority had been criticized for not having enough people to answer calls from citizens interested in signing up for health care.
A spokesman said the problem has been fixed and to date the state has enrolled more than 200,000 people in various health care programs in the past year.
The goal of the law is to insure nearly all residents in Massachusetts.
