Mass. Pols OK Mandatory Health Insurance

[wakeme2008]

http://www.nytimes.com/aponline/us/AP-Massachusettts-Health.html?_r=1&oref=slogin

pril 4, 2006
Mass. Pols OK Mandatory Health Insurance
By THE ASSOCIATED PRESS

Filed at 4:09 p.m. ET

BOSTON (AP) -- Lawmakers overwhelmingly approved a bill Tuesday that would make Massachusetts the first state to require that all its citizens have some form of health insurance.

The plan -- hailed as a national model and approved just 24 hours after the final details were released -- would dramatically expand access to health care over the next three years.


more at link...

[mdmc]

1. good news!

[Ian David]

2. Only 2 people voted against it.

[depakid]

3. "hailed as a national model"

That's wishful thinking... at best.

Sounds more like a grossly underfunded boondoggle to me. Not to mention (and of course the Times doesn't):

"Individuals deemed able but unwilling to purchase health care could face fines of more than $1,000 a year by the state if they don't get insurance."

http://www.boston.com/news/local/massachusetts/articles/2006/04/04/house_senate_set_to_vote_on_final_version_of_health_care_bill/?p1=MEWell_Pos5

That's anyone over 300% of the so called "federal poverty level." Anyone care to offer up a guess as to how much that is?

(hint: it's dirt poor).

[sentelle]

28. Official poverty level

http://aspe.hhs.gov/poverty/06poverty.shtml

9,800 per annum for single person
add 3,400 for each addtional person.

300% numbers are 29,400 and 10200 respectively.
is 39,600 enough for a family of two (single income married)?
is 49,800 enough for married family with child?

[depakid]

32. Goes to show you

that you have to be careful with your math and not get caught in a mindset.

I was thinking 180% of the federal poverty level, which is the eligibility limit for OHP. Obviously, 300% is a bit more than that- so I stand corrected.

Even so, until one sees the numbers for the mandatory insurance policies, I'm going to err on the side of intuition, which tell me that this is going to end up hurting as many people as it helps- and that it's grossly underfunded. It could well be a model for reform all right- a model for what not to do.

[One_Life_To_Give]

53. In Boston anything under 60K should be poverty n/t

[Cobalt Violet]

4. Oh, I don't know about this.

"If all goes as planned, those already insured will see a modest drop in their premiums, lower-income residents will be offered new, more affordable plans and subsidies to help them pay for coverage, and those who can afford insurance but refuse to get it will face increasing tax penalties until they obtain coverage."

I wonder how much you have to make to be concidered "can afford insurance"?

[mondo joe]

23. This might help

http://www.boston.com/news/local/massachusetts/articles/2006/04/04/house_senate_set_to_vote_on_final_version_of_health_care_bill/

The state's poorest are the biggest winners. Single adults making $9,500 or less a year will have access to health coverage with no premiums or deductibles.

Those living at up to 300 percent of the federal poverty level, about $48,000 for a family of three, are also big winners. Under the bill, they will be able to get health coverage on a sliding scale also with no deductibles.

The vast majority of Massachusetts residents who are already insured could see a modest easing of their premiums.

Not everyone may be thrilled with the changes. Individuals deemed able but unwilling to purchase health care could face fines of more than $1,000 a year by the state if they don't get insurance.

[Cobalt Violet]

29. What is 300 percent of the federal poverty level for an individual?

That's going to be what makes or breaks me.

[mondo joe]

31. About $29,400 per year.

http://aspe.hhs.gov/poverty/06poverty.shtml

[Cobalt Violet]

35. That's more than I make.

But I feel bad for those that make $29,500. I'm not sure how this will work.

[HereSince1628]

46. I hearby formally withold my support until I get a chance to read more

I want to know if it in any way tries to push down administrative costs of the US insurance co.

I also want to make sure this thing is puncture proof...that is I wan't to know that it doesn't lead to a general deflation of employer contributions and a rush to get to the minimum contribution. This may be less good for the average worker than NAFTA.

"Forced consumption?" Just how free is the American free market? I am sure that the Founders never saw THAT coming. Are people who for reasons of conscience do not use medical care excluded from forced purchase?

Just what local panel of social conservatives is going to determine that a person _could_ work but isn't? Will it take a doctor's note or a letter from an insurance company to get you a waiver??????

How is insurance purchase responsibility divided among parents at the time of divorce? Are child-support payments excluded from income as they are in most states (thus forcing the payer to make some additional contributions) or will there be an obligation for a custodial parent to purchase insurance with that money?

What sort of protections against insurance fraud and usury are in this bill? Is there a cap on insurance profits, executive pay, exorbitant hospital billing practices (i.e. the $10 box of kleenex, and $20 plastic pitcher and cup)?

[BlackHeart]

5. Sounds like a good reason to move out of MA

especially if you're a 25 year old in good health.

[OKthatsIT]

6. good ridance to you then...

Of course, with an attitude like that, you'll bbe the first to come back when you lose your job, have adisabling accident or get sick.

Get Outta Town!

[BlackHeart]

9. Well don't you think that

it will tend to drive young healthy people out of the state at the same time that it attracts those whose medical needs are the greatest and most costly?

[mondo joe]

24. I think it's more a questin of income than age (though the two

do have some coincidental trending).

The poorest get coverage without premiums.

From there to 30% ofthe federal poverty level, there is a sliding fee scale.

Over 300% of FPL there is a 1k per year charge for not opting into insurance.

[Tesha]

45. Sucks to be compassionate, doesn't it?

Are you sure you're in the right party?

Tesha

[BlackHeart]

47. I'm simply pointing out

the possible negative effect that this law might have. Some people make decisions based on the economic impact that they have on themselves.

[Tesha]

49. Those folks are called "Republicans" and "Libertarians".

> Some people make decisions based on the economic
> impact that they have on themselves.

Those folks are called "Republicans" and, even more so,
"Libertarians".

Democrats, Greens, and Socialists try hard to make
decisions based on the greater good.

Tesha

[lumberjack_jeff]

54. It's more than compassionate, it's pragmatic

Most states require drivers to have liability insurance. Why? Because others should not foot the bill if they get in a wreck. It doesn't matter if you can afford the insurance or not. People who drive without insurance aren't accepting risk themselves, they are choosing to give that risk to others.

This law applies that logic to health care and takes it to the next step by offering to buy the insurance if you can't afford it.

The result of this bill will be a significant drop in the total health care cost for those who live there, and a big windfall for those who try to do the right thing by providing health insurance for themselves and their families.

It'll cost something for those who would choose to let others carry the financial risk that they might get sick, but the truth is, I don't care - this is better for everyone except the irresponsible.

[Proud Liberal Dem]

7. Huh?

I understand the concept of requiring drivers to have automobile insurance so that if they end up being at fault for wrecking another person's car, their insurance company can help pay for the other party's car repair work BUT I do not understand how NOT having health insurance negatively affects other people? Also, with the cost of health care being what we all know that it is, how can anybody truly believe that some people are just too lazy to get themselves some health insurance? How can you "criminalize" not having health insurance when most middle-class families can't afford the steadily skyrocketing costs of health insurance premiums or have to choose between putting food on their table and having health coverage? This legislation sounds awful!

[jwirr]

33. I think the idea is that if all are covered the premiums go down

so if you do not take part you are adversely effecting the costs to others. Also what is to happen if the worst happens and you get hurt/sick and you cannot pay for the cost? Is the group then supposed to take you in as a charity?

[Breeze54]

51. I thought it meant that...

employer's will be REQUIRED to provide health Insurance to workers!!!
Wasn't that the ROOT and motivation for this legislation?? :shrug:
I live in Mass and I don't recall hearing very much about this!!!
I might have recieved an e-mail about health care...hmmmmm
I thought it was about making Plan B available!
Well; I know I got that one but I don't remember hearing about this though!
I better go read my e-mails again!!

OKAY!!!

I found this....

http://www.healthcareformass.org/

The Health Care Constitutional Amendment

***Legislative Update***

Today, April 3, the Senate President and House Speaker announced
far reaching health care reforms that promise coverage to hundreds
of thousands of Massachusetts residents. Their determined and skilled
leadership and the hard work of health access advocates and stakeholders
have shaped these reforms.

State House News Article By Jim O'Sullivan

State House News Article By Amy Lambiaso

After we've had a chance to read the bill,
we'll get back to you with more information.

Today's reforms are tremendously important.
But much work remains to be done if we are
to have affordable access to excellent quality care for every Massachusetts resident.

The Health Care Constitutional Amendment is an essential tool to getting that job done.
It will make sure that the actions taken today serve as a foundation for the future
reforms that guarantee every resident access to affordable, comprehensive and fairly
funded coverage for medically necessary health and mental health care services,
prescription drugs and devices.

This week's votes will clear the decks for action on the Amendment in the May 10th
Constitutional Convention. As soon as we get a second approval from the ConCon
we'll begin our statewide ballot campaign.

We'll need your help over the coming weeks to get that vote.

Together, we will make history.

The Campaign

This campaign is a citizen-led initiative to ensure that every Massachusetts resident
has access to affordable, comprehensive and equitably financed coverage for medically
necessary health and mental health care services.
The proposed Health Care Constitutional Amendment requires the Commonwealth to enact
laws to accomplish this goal.

The Amendment does not, however, dictate any particular solution.

MORE AT LINK...http://www.healthcareformass.org/

[reprobate]

58. A question, jwirr: Have you ever know insurance premiums to go down?

After twenty years in the business I can't recall them ever doing so. Overhead for insurance companies is an ever increasing cost, so premiums always trend up.

If you are referring to the 'pool' being larger, that would be true if it were a single payer system, but they specifically rejected single payer so that wouldn't help. In fact, I would bet that with mandatory insurance you'll see MORE carriers competing for business in the state rather than fewer, resulting in each carrier's pool being smaller and having an upward pressure on premiums.

It's easy to see the insurance industry's influence in this legislation.

Although I know only what the article said about the bill, it's apparent that everything possible has been done to increase profits for the insurance industry. Even to subsidizing premiums for the poor. I'm sure that's proper use of taxpayer funds, to ensure the profits of private industry. What a shame. What a fiasco.

After so long in the industry I have come to the conclusion that private industry has no logical part in health care finance. They have no incentive to improve health care or outcomes for the patient, but every incentive to lower costs which improve their bottom line. That's no way to run railroad!

Every other nation in the world has found the single payer system to be the only workable system to finance health care. Only the United Corporate States of America still insists that the profit motive be used to keep us alive.

I'm reminded of what Winston Churchill once said of us. "You can always count on America to do the right thing......after they've tried EVERYTHING ELSE."

[LiberalEsto]

37. Hospitals provide huge amounts of charity care

for those who are uninsured. This in turn drives up the cost of healthcare for everyone else.

I've heard that some hospitals are refusing to provide indigent care because they claim they are going bankrupt from it.

here's just one article:

Hospital costs soar for indigent care

http://www.bizjournals.com/seattle/stories/2004/09/06/story1.html

[Crowdance]

8. All the cancer survivors will need to flee the state

My last quote for health insurance was almost $30k/year because I'm a cancer survivor. I guess Massachusetts would want to fine me for the crime of having had cancer. This is a goofy law that is a subterfuge: the true solution is to provide all citizens with universal, government funded health insurance.

[newscott]

10. I'm going to have to read up on this measure

But it almost sounds like it's more a requirement that a person be signed up for health care. That means you are not being provided health care. You must get it however you can. Sounds like a win for the insurance companies to me.

[Cobalt Violet]

12. 15 K and still not insured, that's what it would cost you.

They want it to be the fine to be 1/2 the cost of the lowest plan.

[newscott]

13. So they are going to codify shoddy coverage for the poor?

Figures.

[Cobalt Violet]

15. Cheaper plans with less benefits.

[Cobalt Violet]

26. I wonder what "incentives" they will be creating?

"creating incentives for insurers to offer low-cost products with fewer benefits".

[mondo joe]

27. Lower cost will, of course, provide fewer benefits.

But even very basic coverage is important, especially for specialty care and hospitalization.

[Cobalt Violet]

36. Your right about that.

I have a very serious illness and no insurance. It can't be worse of under this plan than it is now. With my employer it would cost me $300 bi-weekly. That I can't afford.

[mondo joe]

38. In WA state we have a program called Basic Health Plan, which provides

basic coverage at relatively low cost. It's been a godsend for a lot of people, especially because it does cover hospital and specialty care.

[Cobalt Violet]

39. We have Mass Health now.

If you make more than $1500. before taxes you don't quailify. I just miss the mark and my employer charges way too much. I think this new program will cover more people which is good.

The devil is in the details. I really don't want to see anyone get hurt by this. My gut tells me that single payer Universal Health Care would still be much better for everyone.

[Trillo]

11. Article seems mightly slim on details.

Maybe there's more information elsewhere.

[Breeze54]

52. Here is more info about this----->

http://www.healthcareformass.org/


http://www.healthcareformass.org/about/faqs.shtml
FREQUENTLY ASKED QUESTIONS

The Health Care
Constitutional Amendment
What will this Amendment do?

* Ensure universal, continuous access to affordable health and mental health care.
* Require elected officials to find a way to make sure every Massachusetts resident
has access to affordable health insurance covering medically necessary health and
mental health care services including prescription drugs and devices.
* Give voters the final approval over a comprehensive plan to implement the Amendment.

Who are the Amendment's supporters?

http://www.healthcareformass.org/about/fact-sheet.shtml
FACT SHEET

The Constitutional Amendment for Affordable Health Care Coverage
WHAT THE PROPOSED AMENDMENT WOULD DO

* Ensure that every Massachusetts resident would have access to the health care they need when they need it.
* Require the Legislature and Governor to enact laws that made sure every Massachusetts resident has affordable, comprehensive and fairly financed health insurance.
* Cover medically necessary health and mental health services including prescription medications and supplies.

WHAT IT WOULD NOT DO

* Require that the state become the insurer.
* Specify any particular mechanism, public or private, for financing expanded coverage.
* Involve the courts in micromanaging our health care system.

THE PROBLEM

* Massachusetts has over 600,000 residents—most of whom work or are members of working families—without insurance, who are often unable to get the care they need, and who suffer needlessly as a result.
* Skyrocketing health care costs threaten those with insurance as the state tries to balance the budget and employers, faced with higher premiums, are forced to raise employee contributions or cut health benefits.
* Providers, including doctors, home health care agencies, hospitals and nursing homes are feeling the funding crunch from reimbursement cuts and increased paperwork requirements. Some have closed; many more are running in the red.
* Despite decades of debate, there has been no meaningful action.

BASIC PRINCIPLES

* Every state resident should have affordable health insurance

More at Links!!

[Sgent]

55. This is a different plan

and not the one that was passed.

The info in the above post refers to the propsed constitutional ammendment by the referenced group -- it has nothing to do with what was passed by the legislature.

[newscott]

14. Now that I think about it my company can now drop all of its coverage

Since they will only have to pay $295 per employee to the state.

It's a big win for employers too. They don't have to carry us on insurance anymore and they pay a fraction of the costs they used to.

They'll be rolling in dough even with the "fees", leaving their employees holding the bag and scratching their heads trying to figure out how this was good for people.

Holy crap, this could be a big mess.

[mondo joe]

19. But your companydoesn't HAVE TO provide coverage

even now, without the $295. Why would having to pay be greater incentive?

[Judi Lynn]

16. Mass. Lawmakers OK Mandatory Health Bill

Mass. Lawmakers OK Mandatory Health Bill
Massachusetts Lawmakers Pass Bill to Require Health Insurance for Everyone
By STEVE LeBLANC

BOSTON Apr 4, 2006 (AP)— Lawmakers overwhelmingly approved a bill Tuesday that would make Massachusetts the first state to require that all its citizens have some form of health insurance.

The plan approved just 24 hours after the final details were released would use a combination of financial incentives and penalties to dramatically expand access to health care over the next three years and extend coverage to the state's estimated 500,000 uninsured.

If all goes as planned, poor people will be offered free or heavily subsidized coverage; those who can afford insurance but refuse to get it will face increasing tax penalties until they obtain coverage; and those already insured will see a modest drop in their premiums.

The measure does not call for new taxes but would require businesses that do not offer insurance to pay a $295 annual fee per employee.
(snip/...)

http://abcnews.go.com/US/wireStory?id=1805733

[GrumpyGreg]

17. Another brick on the walkway of Romney's march to the White House.

[Ian David]

18. My only problem with it is requiring INDIVIDUALS to buy insurance

Otherwise, I think this bill is excellent.

Make Wal-Mart pay their fair share.

[Cobalt Violet]

20. Of course that was the part of the bill Romney insisted on.

:puke: I don't know if I can do that. I'm trying to figure out how much 300% of the federal poverty rate is for an individual.

[mondo joe]

30. About $29,400 per year.

[newscott]

21. I believe in making company's pay their fair share

but what if the unintended consequence is that all companys now feel they have a mandate to drop all health coverage for the cheaper $295 fee, knowing full well that their employees will have to foot the rest on their own?

[mondo joe]

25. Question: Employers are not required to provide insurance now,

but do - so what incentive would there be to drop it under the new plan?

[newscott]

34. I'm just speculating here is all. I don't know if there would

necessarily be an "incentive" per se, but perhaps this will give some the "rationale" they need to tell their employees "Hey, look the company will save a ton of money and we'll pass that on to the executives, I mean you folks!"

Call me a cynic.

[whododayis]

41. employer point of view

As an employer of 25 people who currently offers 80/20 health coverage, I would love to pay "only" $295 per year per employee. Currently I offer employees who don't want or don't need (have spousal coverage) the cash equivilent of what their premium would be each month (about $150 per person). What sucks for them is that after taxes on the extra money they only net out about two-thirds of it. If I were a large employer, I'd relocate to Mass. to save on the benefit cost. I looked into buying emergency/catastrophic coverage which I would pay for 100% for all of my employees and the dependents, but my employees said that they'd rather have HMO type coverage even if they had to pay $75 per month in premiums and a $20 co-pay for doctor's visits.

[converted_democrat]

42. I thought I had the answer, but I'm going to ask an accountant first..n/t

[mondo joe]

22. More detail on poverty assistance here:

The state's poorest are the biggest winners. Single adults making $9,500 or less a year will have access to health coverage with no premiums or deductibles.

Those living at up to 300 percent of the federal poverty level, about $48,000 for a family of three, are also big winners. Under the bill, they will be able to get health coverage on a sliding scale also with no deductibles.

The vast majority of Massachusetts residents who are already insured could see a modest easing of their premiums.

Not everyone may be thrilled with the changes. Individuals deemed able but unwilling to purchase health care could face fines of more than $1,000 a year by the state if they don't get insurance.

http://www.boston.com/news/local/massachusetts/articles/2006/04/04/house_senate_set_to_vote_on_final_version_of_health_care_bill/

[NashVegas]

40. Great Idea, But How Does It Help Health Care Costs?

iow, this sounds like a HUGE boon for hospitals and for-profit care providers, and a little boon for some people who already have health insurace. A pill for people who don't have it but can afford to.

Health insurance costs are outrageous because health care costs are wildly uncontained. Free-marketers will tell you "whatever the market will bear" is how it should be.

This subsidization artificially helps the market to to continue to bear a whole helluvalot.

It's a nice idea, I just wonder about the long-term consequences as health care chews up more and more of the national spending pie, both for individuals and the gov't.

[Lifelong Protester]

43. Something about this doesn't work for me...

maybe i am too dense, but does the state of MA think that people aren't insured because they CHOOSE not to be? My employer provided health insurance now runs $16,000 a year, and will go up another 10% this coming year. I realize there must be cheaper plans out there but define 'cheaper'. I make good money, but could not afford that quality of health insurance ( as I have now) on my salary.

So to me, seems like the working middle class can get squeezed yet again. As it becomes more and more each person's required burden to buy heatlh coverage, what incentive is there for employers to keep offering it? What incentive is there to do anything about universal coverage other than the same type of thing that has happened to the Medicare prescription drug plan, a byzantine plan if ever there was one.

I think I get your argument on how this will bring health coverage to the poor, but most states already have that type of coverage.

It is the middle class that is continuing to take it on the chin here.

Maybe I am missing something??

[classics]

44. The uninsurable yet not poor will flee the state, no other choice.

Pay $2000+ per month for a plan with a tiny high-risk benifits cap or pay a government fine.

What about people who are literally uninsurable? There are plenty of people who cannot get health insurance from any company, at ANY price, even if paying for it is not an issue.

[area51]

56. "What about people who are literally uninsurable?"

I'm glad you brought this up. In other threads in the past, I've seen DU'ers tell about how they can't get insurance due to a pre-existing condition. Also, what about people like the DU'er who mentioned they're a cancer survivor & insurance is out of their financial reach?

[Nye Bevan]

48. Sounds like a good system

Excellent news for Massachusett's poorest. Kudos to Ted Kennedy for his role in this.

And this *could* potentially be a national model-- it will be interesting to see how well it works in practice.

[Beall]

50. I think this is Great News for Massachusetts

However with the Enzi bill 1955, which is coming up for a vote soon, if it passed it would wipe out state control mandating state health insurance. I am worried that if it passed, it would wipe out all of Massachusetts valiant efforts to create healthcare for everyone.

[depakid]

57. Mike Enzi, R-Wyo.

Republicans always have an answer.

“The Health Insurance Marketplace Modernization and Affordability Act of 2005.”

[ed murrow]

59. Enzi Would Threaten Romney's Bill

I know it not Romney's bill but I at least give him credit for being willing to sign it into law.

This is such a greta step for healthcare in America but I seriously worry that this Enzi Legislation would completely undermine it.

There is a great diary on Daily Kos that is discussing this issue.

http://www.dailykos.com/story/2006/4/6/13942/74890">Daily Kos - Enzi & Mass Health Bill

ed