Mass. groups back ballot initiative on universal healthcare

Backers of universal health insurance yesterday refused to throw their support behind a compromise to expand coverage that is emerging in the Legislature unless the plan becomes law, and vowed to continue pushing for a far costlier 2006 ballot initiative that would hike cigarette and payroll taxes to bring healthcare to all in Massachusetts.

Members of the Greater Boston Interfaith Organization, a coalition of 65 local religious institutions, and Health Care For All said they would press ahead with the ballot initiative until they were satisfied that the legislative compromise had been enacted and that it represented, in the words of one activist, ''a true expansion of healthcare."

The tough talk raised the prospect of an expensive ballot fight that could pit liberal groups like the interfaith organization against business groups and perhaps tobacco companies. GBIO members have gathered 113,000 signatures for the ballot initiative and said yesterday they would continue mobilizing for an additional 20,000 to ensure the proposal makes the November ballot.

''This really is about a substantial expansion of healthcare -- if that's what this is, the people will applaud," said Rabbi Jonah Pesner, a GBIO leader, reflecting on the healthcare compromise emerging in the Legislature. ''If this doesn't reach that substantial expansion of access, the people will go to the ballot."

Pesner said the legislative plan, still in negotiations in the House and Senate, was too lacking in detail to determine whether it met what he called a ''moral imperative" to provide health insurance for the approximately 500,000 people who go without coverage in Massachusetts. GBIO leaders said they would try to decide by July whether to abandon their ballot plan.

John McDonough, a former state lawmaker and executive director of Health Care For All, an advocacy group, called the legislative compromise a ''hugely significant breakthrough" but cautioned that there were too many stumbling blocks left -- in Washington and on Beacon Hill -- to guarantee the plan would become law.

Until then, he said, Health Care For All members would reserve judgment on the compromise because they had worked too hard on the ballot campaign and believe the citizen plan is helping to compel recalcitrant lawmakers to act on healthcare reform in the Legislature.

McDonough added that while Health Care For All considers a legislative bill preferable to a voter initiative, state lawmakers have only made public ''the tip of the iceberg of their plan."

''So there is a large array of critically important details that are just unknown," McDonough said.

Another factor: Governor Mitt Romney, who has praised lawmakers for moving ahead with healthcare negotiations, has not said whether he will sign the bill into law. Yesterday, Julie Teer, a Romney spokeswoman, echoed McDonough, saying the plan on Beacon Hill is too lacking in detail to say whether it would be vetoed.

The plans from both sides differ in scope and cost. The legislative plan aims to make the state eligible for $385 million in federal Medicaid money. Under the agreement between House Speaker Salvatore F. DiMasi and Senate President Robert E. Travaglini, the plan would assess companies with 10 or more employees that do not provide health coverage $295 a year for each worker, say several negotiators, who spoke on the condition of anonymity. A senior legislative aide has estimated the plan would eventually cover half to two-thirds of the state's uninsured. Lawmakers have refused to provide more details.

Under the initiative backed by activists, nearly everyone without health insurance in Massachusetts would receive coverage, backers say. The bill would pool money currently spent on healthcare and new funds from the federal government, and impose a 60-cent tax increase on cigarettes. In exchange, it would guarantee coverage for the poor through MassHealth or by helping with payments for health insurance purchased through employers. Employers would have to either provide health coverage or pay a fee to the state, the bill says.

''That's what's really driving this," Pesner said, ''the moral imperative and the popular imperative to insure the uninsured."