Will public buy the healthcare plan?

BUSINESS HAS bought in, but will the public?

That's the question with the state's new healthcare legislation.

On Wednesday, Governor Romney held a listening session with business leaders about the bill, which the Legislature overwhelmingly passed on Tuesday.

''It was a very positive meeting," reports Paul Guzzi, president of the Greater Boston Chamber of Commerce. ''There is buy-in by a significant portion of the employer community."

One noted dissenter had been Chris Anderson, president of the Massachusetts High Technology Council. No surprise there. The council is more conservative than other business associations and more prone to seeing state government as a leviathan against whose encroachment constant vigilance is required.

So imagine my surprise when I asked Anderson how to characterize his feelings on the legislation after the meeting and got this reply: ''Supportive."

Supportive?

''The bill could be a national model if implemented properly," said Anderson, who added that Romney had persuaded him it would be.

All that tells you something important about the difference between this attempt to expand healthcare and the effort the state made in 1988 under former Governor Michael Dukakis.

The approach then was a pay-or-play scheme, under which businesses either had to offer health insurance or pay $1,680 into a state fund for that purpose. That had many in the business community up in arms.

When the pot was sweetened sufficiently to win the hospitals' support, the legislation finally passed. But without business backing, it didn't survive. The law never actually took effect, and after Republican Bill Weld became governor, it was repealed.

So why does this legislation have better prospects? ''This time there is more buy-in by the business community," notes Phil Johnston, who was then state secretary of human services and later regional director of the US Department of Health and Human Services. ''The individual mandate is the philosophical breakthrough."

It is for the institutional players, anyway. Businesses, hospitals and providers, insurers, and advocates are basically aboard, seemingly committed to making it work.

Now comes this crucial question: How will it sit with the individuals who will be required to buy health insurance? The answer: No one quite knows.

The state will help those of low and moderate incomes with health insurance costs. But as everyone concedes, the legislation's success hinges both on the size of the subsidies offered and availability of affordable plans.

For individuals, subsidies end at about $29,000. Premiums have yet to be determined, but yesterday the Globe's Liz Kowalczyk reported that they may average about $325 a month for an individual plan. That translates to $75 a week; even pre-tax, it's a big bite for someone whose gross income is only about $560 a week.

''It is all a question of what it is going to cost people," notes Dukakis. ''If a guy making $30,000 is going to have to come up with $3,600 or so, you are hitting people of very moderate incomes pretty hard."

Tim Murphy, Romney's secretary of Health and Human Services, still expects some plans ''in the low $200 a month range," which would certainly make the individual mandate an easier sell.

But the state's healthcare experiment will still require a concerted effort to convince state residents, particularly healthy young people who don't see the need for coverage, that this is the best approach.

Johnston, for one, is convinced that that can be done.

''The business community is very committed to helping change the culture," he says. ''I think that will have an impact."

Yet for that to happen, there will have to be a smart public-education campaign.

There will be sanctions for not buying coverage, of course. They begin in 2007, with loss of one's personal state income-tax exemption, about a $200 hit. In subsequent years, financial penalties equal to half of the premium of an affordable plan (for the uncovered period) will be assessed.

Still, the state should put an emphasis on persuasion, not penalties. The effort to educate people needs to treat them as intelligent adults.

Despite the national headlines this legislation has attracted, its success won't be assured until there is buy-in -- figuratively and literally -- right here at home, among Massachusetts citizens.

Scot Lehigh's e-mail address is lehigh@globe.com.