Healthcare plans' similarities, differences
Both Governor Mitt Romney and House Speaker Salvatore F. DiMasi have proposed healthcare plans that would require everyone to have some sort of health insurance, a so-called ''individual mandate." The two measures share many features, but there are also significant differences between them.
Who would it apply to?
Romney plan: Everyone who is not covered by Medicare or MassHealth, the state's Medicaid program, would have to either buy insurance or set aside $10,000 in a ''medical escrow account" to cover medical costs. State subsidies would be available to individuals making up to $28,710, or three-times the federal poverty level. The governor would preserve the current eligibility standards for MassHealth.
DiMasi plan: Same requirements, although the plan would loosen the income restrictions for MassHealth so the government-funded program would cover an additional 145,000 people. Also, people would be exempt from the individual mandate if, under a yet-to-be-devised formula, the state determined that they could not afford any insurance plan on the market.
How would it be enforced?
Romney plan: Massachusetts residents would be asked for proof of insurance when they went to seek care. If they did not have insurance and refused to enroll in a plan or set up an escrow account, the state would deny them the personal exemption on their state income taxes ($3,300 for an individual and $6,600 for a family) or withhold their tax refund and deposit it in an escrow account to pay for care.
DiMasi plan: Beginning in April 2008, residents would have to check a box on their state tax forms certifying that they were insured during the previous year. To verify the information, the state's Division of Insurance would maintain a database with the names of all insured residents, updated monthly. People without insurance for any portion of the year would have to pay a fine. The fine for each month without insurance would be 50 percent of what the taxpayer's monthly premium would have been. People refusing to pay the fine for more than 60 days would not be able to renew their driver's licenses. The state's Group Insurance Commission would grant exemptions to people not earning enough to afford insurance.
What kind of coverage would be available?
Both Romney and DiMasi are counting on insurers to create new insurance plans costing about $200 a month (or even less for people ages 19 to 26 under DiMasi's plan). They both would provide state subsidies to individuals making up to $28,710 a year. With the subsidies, an individual's weekly premium would range from $2.30 to $32.31, depending on income.
Both proposals envision annual deductibles as high as $1,000 and co-payments as high as $40. The DiMasi plan would not allow insurers to eliminate any of the benefits mandated by the state, but Romney's plan would.
SCOTT S. GREENBERGER 