Health initiative gaining support, according to poll

The state's health insurance initiative gets strong support from Massachusetts residents, even though most believe it will result in higher taxes, according to a poll of 1,003 people being released today.

Two-thirds of state residents who know about the initiative said they support the effort to insure nearly all adults, largely because it "is the right thing to do." And nearly as many think the effort will ultimately prove successful. Two-thirds also think their taxes will increase because of the initiative, even though the plan is currently supported with existing state and federal funds.

The poll also found that the insurance law, passed more than a year ago, is gaining support as more people learn about the initiative's specifics.

"There's a sense of optimism that this can be done," said Robert J. Blendon, a professor of health policy at the Harvard School of Public Health, who helped conduct the poll. The national Kaiser Family Foundation and the Blue Cross Blue Shield of Massachusetts Foundation, both of which advocate broader access to healthcare, also worked on the poll.

Blendon said the growing support stands in stark contrast to the public's reaction to former President Clinton's national health insurance plan more than a decade ago. In that case, the more people knew about the plan, the less they liked it, he said.

The initiative requires all adults to obtain insurance by July 1 if it is affordable and imposes penalties starting Dec. 31 for those who don't. State-subsidized insurance is available for low-income persons, and the state has authorized lower-cost private insurance plans for others. In addition, businesses with more than 10 employees are required to provide coverage for employees or pay a fine.

Yesterday, the Commonwealth Health Insurance Connector Authority, the state agency overseeing implementation of the law, finalized the standards that will be used to determine if insurance is affordable and therefore required.

The standards set out a sliding scale of maximum affordable premiums based on income. A family with an adjusted gross annual income of $60,000, for example, would be exempted from the insurance requirement if they could not find coverage for $320 a month or less. The standards will be posted on the authority's website, mahealthconnector.org, along with tables listing the least expensive insurance available.

Yesterday's action puts in place the last essential element of the initiative. But even with the affordability exemptions, the public is still concerned about the affordability of private insurance, according to the poll.

When people were given actual examples of nonsubsidized coverage and costs for a single person and a family, roughly 60 percent said the insurance was too costly and required so many out-of- pocket payments that it would leave insured people vulnerable to high medical bills. By contrast, those polled thought the subsidized plans offered solid protection at reasonable cost.

Another area of concern highlighted by the poll was the effect on small businesses. While most people said the law would help the poor, the uninsured, and the young, more than 50 percent said they thought it would hurt small businesses. Several small business organizations have lobbied against the law.

Support for the law was weaker among those whom it is designed to help. Only 48 percent of people who have been uninsured at some point in the last year supported the insurance requirement. Nearly one-quarter of those who have been uninsured knew nothing about the law, the poll found.

The poll was conducted by telephone in late May and early June, before the state launched a major advertising campaign. The poll has a margin of error of plus or minus 4 percentage points.

"This argues for continuing strong efforts to do outreach," said Jarrett Barrios, president of the Blue Cross Foundation.

Jon Kingsdale, executive director of the authority, called July 1 "a time to get very, very serious about looking at insurance," rather than a deadline.

"We've always thought this was going to be a two-year implementation," he said. "We're halfway through that, and the great majority of people continue to support reform."