Activists push Romney, Travaglini to do more on healthcare

Nearly 1,000 activists upstaged Governor Mitt Romney and Senate President Robert E. Travaglini at a State House hearing yesterday, demanding that the state go further than either leader has suggested to provide healthcare coverage to everyone in Massachusetts.

The demonstrators politely applauded after Romney and Travaglini testified before the Legislature's healthcare financing committee. But hundreds of them stood in unison in the sweltering auditorium as the Rev. Hurmon Hamilton of the Roxbury Presbyterian Church spoke to the Joint Committee on Healthcare Financing.

''We think you have a divine opportunity to make quality healthcare reform in the state of Massachusetts," Hamilton said. ''The state should be able to say the same thing the Samaritans did -- whatever it costs is worth our pain."

Romney and Travaglini want to make private insurance more affordable by allowing insurance companies to offer lower-cost policies with scaled-back benefits. But the demonstrators say covering all of the roughly 500,000 uninsured people in Massachusetts is impossible without raising additional money -- perhaps through a hike in the state cigarette tax -- and a requirement that all but the smallest employers provide coverage to their workers.

For months, the ''market-based" approach favored by Romney and Travaglini has had the upper hand on Beacon Hill. But yesterday's well-organized show of force -- the leaders of the demonstration wore fluorescent-orange vests so the ground troops could easily identify them, and distributed granola bars and bottled water from a temporary headquarters near the base of the Grand Staircase -- suggests that momentum is building for a more far-reaching healthcare proposal.

Late last month, the Greater Boston Interfaith Organization, which includes 65 religious congregations and community groups, launched a drive for the 2006 state ballot with a healthcare proposal that includes a tax hike and a requirement that employers cover their workers. Members of the group, who wore matching blue T-shirts, made up a large portion of yesterday's crowd.

''The momentum shifted dramatically today," said Rabbi Jonah Pesner of Temple Israel in Boston. ''This is bringing together people of every faith background, every racial background, every ethnic group, and every economic class . . . in a community of morality."

John McDonough of Health Care for All, an advocacy group that is helping lead the charge for a more far-reaching measure, saluted the demonstrators during a noon rally in Nurses Hall.

''There is so much power in this room," said McDonough, who as a state representative coauthored the state's last major healthcare expansion in 1996. ''Thank you for being witness to the sin, the immorality, to the insanity of our healthcare system."

But in their remarks yesterday, Romney and Travaglini reiterated their support for a plan that mostly relies on the private market to expand coverage. And business leaders, who testified yesterday, have made it clear that they will strongly oppose any effort to place a mandate on employers.

''No responsible person would suggest that we can expand health insurance to everyone, cut healthcare costs, and improve quality without spending any more money on healthcare and without imposing any mandates on businesses," Travaglini said. ''But, we must ensure that our proposed solutions do not cause more harm than they do good. Raising broad taxes or imposing broad business mandates could drive jobs out of the Commonwealth of Massachusetts and undermine the continuation of this recovery."

Travaglini's plan, which he says would cover about half of the uninsured, does not include an ironclad requirement that employers cover their workers, but it would force companies that employ 50 or more people and don't provide healthcare coverage to reimburse the state when their employees seek treatment from the public ''free care pool."

His plan also calls for $116 million to increase payments to Medicaid providers; an extra $25 million for public health programs such as cancer screenings; and $15 million to reimburse insurers for claims between $100,000 and $500,000. The last expenditure is designed to dissuade insurers from raising premiums on everyone to cover catastrophic costs.

Romney argues that the state can cover nearly everybody with a market-based approach. He also believes it can avoid spending new money by wringing savings out of the current system.

''We don't need new taxes to provide healthcare for all of our citizens," Romney told reporters after his testimony. ''As President Travaglini indicated, we're spending about a billion dollars now covering the uninsured, giving them healthcare. By taking that billion dollars and using it to subsidize health insurance products purchased by these individuals, we can get everybody insured with the money we're already spending."

Senator Mark C. Montigny, who worked with McDonough on the healthcare bill in the mid-1990s, said yesterday's crowd is evidence that the state's healthcare system has reached a crisis point. ''We wouldn't have filled this building five years ago," the New Bedford Democrat said. ''The members have to say to the Senate president and the speaker, 'We want to go further.' "