Half-hearted on health

THE MASSACHUSETTS Senate is moving quickly to approve its own package of healthcare bills. Many senators vigorously backed improved access to healthcare in the past. They must know that the measures approved by their Ways and Means Committee do not go far enough to reduce the number of people without health insurance.

The two bills to be considered today are little changed from those introduced by Senate President Robert Travaglini last spring. One provision would penalize companies with 50 or more workers who do not have insurance. If their workers receive care paid for by the state uncompensated care pool, the state would demand reimbursement from the companies. And, under the Travaglini plan, the state would subsidize expensive care for workers in small businesses that provide insurance. This ought to lower the cost of coverage for many companies.

These proposals, while worthwhile, only nibble around the edges of a larger problem: Hundreds of thousands of people in Massachusetts lack health insurance either because they don't want it, can't afford it, or their employers don't offer it. Travaglini thinks his bill would reduce the number of uninsured by 225,000. MIT economics professor Jonathan Gruber puts the reduction, more realistically, at 52,000.

Travaglini's bill is less innovative than the plan proposed by Governor Romney, who wants to require everyone in the state to get health insurance. It is less comprehensive than the bill proposed by House Speaker Salvatore DiMasi, which combines the individual mandate concept with an assessment on employers who do not offer coverage. Money from the assessment would help subsidize insurance for people who could not otherwise afford it. The House overwhelmingly passed the speaker's bill last week.

The Senate ought to be debating the merits of an individual mandate, but Travaglini would consign those deliberations to a study. Senators also should be considering whether the employer assessment is the best way to pay for expanded coverage. Travaglini insists that his bill will not contain any broad-based new revenue.

During the last budget crisis, the Senate did its best to mitigate the impact of budget cuts on state healthcare programs. Now the economy has improved, and, in a rare policy conjunction, the governor and the House both favor dramatic expansions of insurance programs. This is an opportunity that comes rarely and should not be squandered by excessive caution or legislative rivalry. It is time for the Senate to seize the moment and bring the state closer to 100 percent healthcare coverage.