Mend the healthcare bill

MEMBERS OF the business community, Governor Romney, and Senate President Robert Travaglini are criticizing a bill that for the first time in nearly two decades holds the promise of providing health insurance to most people in Massachusetts. The proposal advanced by House Speaker Salvatore DiMasi can surely be improved, but its central concepts are sound.

DiMasi's aides were working yesterday on a possible problem with the bill's funding formula discovered by the Massachusetts Taxpayers Foundation. Companies top-heavy with high-salaried employees could face an assessment under the bill even though they already offer health insurance to most of their staff. These companies shouldn't have to pay extra; it is not what DiMasi intended, and the problem can be fixed with an amendment.

But this dispute does not change the fact that hundreds of thousands of Massachusetts residents lack health insurance. When they are sick, their treatment is paid for by the uncompensated care pool. Employers of these people should pay a special assessment to defray the cost of insurance that would minimize overuse of the pool.

The speaker's proposal is being criticized as an antijobs measure. A survey done earlier this year found that Wal-Mart, Stop & Shop, and Dunkin Donuts led the list of companies whose workers lack insurance. It is unlikely they will leave the state.

The speaker's plan would refine an idea first proposed by Romney, that everyone in the state should be required to buy health insurance. The governor is right that there should be no free riders in the system, but the actual insurance plans under Romney's approach would probably include high deductibles and copays. New revenue is required to improve benefits and make the policies affordable.

DiMasi's plan would phase in an assessment on employers which, when fully implemented in July 2007, would be 5 percent for small businesses (with fewer than 100 workers) and 7 percent for larger businesses. Those with 10 or fewer workers would be exempt. If the Legislature wants to cap the assessment at a lower rate, it will need to consider alternative sources of revenue, such as a cigarette tax increase.

Then-governor Michael Dukakis persuaded the Legislature in 1988 to pass a law that would have compelled employers to provide health insurance or pay into a fund to cover workers outside the employer-based system. It was never implemented. The DiMasi plan doesn't have the sweep of the Dukakis mandate, but it is doable in today's economic climate. The bill is scheduled to be considered by the House today. The Legislature should improve it, not bury it.