A healthy landmark
HOUSE SPEAKER Salvatore DiMasi is right when he says the compromise bill announced yesterday is only the beginning of a state campaign to make sure everyone in Massachusetts is protected by health insurance. But it is a major step forward, and deserves the full support of Governor Mitt Romney once the Legislature, as expected, approves it today.
The bill would finally do what people knowledgeable about healthcare have suggested for years: move state policy away from reliance on the uncompensated care pool and toward insurance coverage. It does this while striving to preserve $385 million in special payments from the federal government.
The pool now pays hospitals to treat people when they are ill, a perverse incentive toward costly care. It's time the state adopted an insurance model that emphasizes preventive measures and early intervention to lessen the impact of disease.
Upward of 500,000 people in the state now go without insurance. The aim of the bill is to cover 95 percent of them within three years. Private insurers would be given the task of devising policies that would be affordable to people of limited means yet comprehensive enough to provide essential care. The state would help by giving financial subsidies to those earning up to 300 percent of the federal poverty line ($48,270 for a family of three). Only time and experience will determine whether these subsidies are sufficient, and whether people earning just above that amount will be able to afford the policies private insurers would offer.
At a press conference yesterday, Governor Romney praised the bill as a landmark. And many of the bill's features are drawn from his proposal last year, especially a provision that everyone in the state be mandated to get health insurance. This sends a message that people can not think first of the free care pool for emergency care, but must take the initiative to get themselves insured.
But the governor didn't say whether he would accede to the most controversial item in the bill -- an assessment on employers of more than 10 people that do not offer health insurance. This fee, which would not exceed $295 per employee, represents a modest acknowledgement that all employers have a responsibility to help their workers get coverage. The governor has the power to veto portions of the bill, but he should accept this small improvement in his original proposal.
It would be wonderful if Massachusetts could insure everyone immediately, but the state lacks the size, money, and autonomy from federal control to do that. The alternative is to move incrementally. DiMasi and Senate President Robert Travaglini deserve credit for the biggest advance in a decade toward the goal of health insurance for all. 