Mass. Lawmakers OK Mandatory Health Bill

AR182

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what is the over/under number of how long will it be before the taxes are raised in mass.?....



Mass. Lawmakers OK Mandatory Health Bill By STEVE LeBLANC, Associated Press Writer

BOSTON - 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.

The cost was put at $316 million in the first year, and more than a $1 billion by the third year, with much of that money coming from federal reimbursements and existing state spending, officials said.

The House approved the bill on a 154-2 vote. The Senate endorsed it 37-0.

A final procedural vote is needed in both chambers of the Democratic-controlled legislature before the bill can head to the desk of Gov. Mitt Romney, a potential Republican candidate for president in 2008.

Romney has expressed support for the measure but has not said whether he will sign it.

"It's only fitting that Massachusetts would set forward and produce the most comprehensive, all-encompassing health care reform bill in the country," said House Speaker Salvatore DiMasi, a Democrat. "Do we know whether this is perfect or not? No, because it's never been done before."

The only other state to come close to the Massachusetts plan is Maine, which passed a law in 2003 to dramatically expand health care. That plan relies largely on voluntary compliance.

"What Massachusetts is doing, who they are covering, how they're crafting it, especially the individual requirement, that's all unique," said Laura Tobler, a health policy analyst for the National Conference of State Legislatures.

The plan hinges in part on two key sections: the $295-per-employee business assessment and a so-called "individual mandate," requiring every citizen who can afford it to obtain health insurance or face increasing tax penalties.

Liberals typically support employer mandates, while conservatives generally back individual responsibility.

"The novelty of what's happened in this building is that instead of saying, `Let's do neither,' leaders are saying, `Let's do both,'" said John McDonough of Health Care for All. "This will have a ripple effect across the country."

The state's poorest ? 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, or about $48,000 for a family of three, 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.

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.

Romney pushed vigorously for the individual mandate and called the legislation "something historic, truly landmark, a once-in-a-generation opportunity."

One goal of the bill is to protect $385 million pledged by the federal government over each of the next two years if the state can show it is on a path to reducing its number of uninsured.

The U.S. Department of Health and Human Services has threatened to withhold the money if the state does not have a plan up and running by July 1.
 

AR182

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surprised that there are no comments on this....

i think if romney agrees with this bill...he can kiss his presidential aspirations goodbye.....no way will the republican party vote for a guy who is pushing universal health care for his state....

i also think that the quality of health care in mass. will eventually suffer because demand will overwhelm supply......

i would like to hear what others have to say, especially those living in mass.....

stevied any comments ?
 

Chadman

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Thanks for posting this, AR. I am just starting to look into it and don't have a strong opinion. If this is something that could somehow reduce the ability for health care providers to continue raising the rates for those of us who pay such high prices for our insurance, maybe it has some merit. But I don't know how or why it would. Would love to hear from some who know the program or the insurance business better. I am certainly not sold on it until looking more. But I keep hearing that one of the main reasons my premiums are so high is because I am paying for healthcare for the uninsured. Maybe this could help those of us who DO pay for our own premiums? I dunno, just tossing it out there. Good topic for serious study and conversation.
 

buddy

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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.

LOL!

$295 annual fee per employee!

The average employee insurance premium is $500 - 700 PER MONTH !!
 

StevieD

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I don't know too much about this AR. Insurance is one of many things I do not understand. I do know, that right now if you can't afford medical care the state will cover it. So maybe this will actually save the Commonwealth money in the long run.
 

AR182

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here is an article about hillary praising the plan...

A Massachusetts plan that blends the Democratic goal of universal health care with the Republican philosophy of personal responsibility could be a model for politicians nationwide - and a presidential launching pad for its chief sponsor, GOP Gov. Mitt Romney.

The proposal, approved Tuesday by Massachusetts' Democratic-led Legislature, won Romney cautious praise from Democrats, including a longtime champion of health care overhaul: Sen. Hillary Rodham Clinton of New York.

"To come up with a bipartisan plan in this polarized environment is commendable," said the former first lady, who led President Clinton's failed health care campaign.

She embraced the Massachusetts measure's most striking aspect - requiring people to purchase health insurance - but questioned Romney's plans to eliminate a fee on companies that do not provide health insurance for employees.

"That would unravel the plan," Clinton said.

Policy squabbles aside, Democratic and Republican strategists agreed that the legislature had handed Romney a timely political victory. The Massachusetts governor announced in December he would not seek a second term, giving him the freedom to explore a likely bid for the GOP nomination in 2008.

Romney, 59, now has a signature achievement on an issue that polls show is a growing concern for U.S. voters. It also adds weight to the argument that his experience as a Republican in a Democratic state would help Romney break the partisan gridlock of Washington.

Romney, whose father ran unsuccessfully for the GOP presidential nomination in 1968, said he understood the presidential implications of the health care bill but he didn't want to talk about them.

"I have nothing to add to that," he said with a laugh. "I actually ran with (health care reform) as something that I wanted to do. If there are national implications and applicability, that would be wonderful."

Romney said he suspected that the bill could be a model for changes in other states, if not nationwide.

"This is a Democratic ideal, which is getting health care for everybody, but achieved in a Republican way, which is reforming the private marketplace and insisting on personal responsibility," Romney said in a telephone interview.

"I do think people look to see cooperation from both parties and are tired of 'gotcha' politics. They are looking for people to help solve problems rather than just point out failures, and I'm proud that my legislature here ... was able to collaborate on something and make a huge difference."

The Massachusetts plan would allow uninsured people earning less than the federal poverty level to obtain subsidized policies that have no premiums. They would make small co-payments for emergency room visits and other services.

People earning between the poverty threshold and three times that amount would be able to buy subsidized policies with premiums based on their ability to pay.

Residents will be required to provide proof of their health insurance policies on their state income tax returns. Those who do not have insurance would lose their personal state exemption, worth about $150, and eventually face stiffer penalties equal to half the cost of the cheapest policy they should have purchased.

Waivers can be given to people who can't find insurance.

Many details still need to be worked out, including exactly how much low-income residents will pay for the new policies.

The bill requires companies to pay $295 a year for every employee they do not provide with insurance. Romney will try to eliminate that provision, saying it's not needed to pay for the program, and trim Medicaid increases approved by legislature.

Democrats have the votes to override him. If they do, Romney will still be able to argue on the campaign trail that he got his bill and fought against the business fee.

Polls suggest that most voters want government to fix the health care problem without taking it over. There seems to be only limited support for either a single-payer system backed by liberals or the health care savings accounts favored by conservatives.

With federal reforms caught in Washington's gridlock, Romney and other state leaders are filling the void with programs that spread the expense and accountability between government, business and individuals.

Illinois approved a subsidy plan last year that will dramatically increase coverage for needy children. Iowa provides health insurance for every resident earning less than 200 percent of poverty level. Both states are run by Democratic governors.

"In absence of a national policy, states are doing what we can to address the issues," said Iowa Gov. Tom Vilsack, who is also exploring a 2008 presidential bid. He praised Romney's approach.

Even Democrats who questioned his policy admired Romney's politics.

"It's a feel-good story, this Romney thing. Republican Governor. Democratic legislature," said James Carville, architect of President Clinton's 1992 campaign and an advocate of single-payer health insurance. "Romney is an ascendent guy."
 

Nosigar

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New Mass. flag


100px-Danghui.svg.png
 

Master Capper

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Why the consept is okay it's only a matter of time before someone takes this to court and it is tossed out! The comparison to folks being requirred to carry auto insurance really is not an accurate comparison since auto insurance is being used to cover damages that you may cause to another person whereas the health insurance coverage is used to cover damages to yourself which is technically a huge difference. We cannot regulate someone to take good care of themselves as this is next to impossible, would it be acceptable to put into law regulations that require obese people to forego throwing down those triple big macs with the super sized fries because in the long run it will save all of us $$ with the improvement in their health?
 

Spytheweb

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Healthcare in America is not a right

Healthcare in America is not a right

Not when there is a dollar to be made. No healthcare, jobs going overseas and the borders being opened up. Doesn't being a American mean anything anymore? The US will pay billions to kill people (Iraq) but will not use the same money to save lives. When i was young you could go to the doctor and pay out of your pocket, now in America you can't afford to get sick. Why must i die because i'am an American? The word greed should be added to the flag, when is enough, enough! Anyone who runs on healthcare i will vote for.
 

StevieD

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Have to agree with you Spy. This may be a first step in reeling the medical profession in.
 

djv

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One thing for sure insurance cost are out of control more then gas problem. And tort reform is about 5% of answer. All those that are not insured are 25% of problem. So Answers are needed. Or most here will not be able too own insurance. If we like it or not we already are sharing the cost.
 

AR182

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i agree that something should be done about the medical costs......but not at the cost of care....

all i can tell you stevie is that all of the pop. of mass. should start saving your money because if this happens....you will get a large tax increase...
 

Nosigar

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AR182 said:
i agree that something should be done about the medical costs......but not at the cost of care....

all i can tell you stevie is that all of the pop. of mass. should start saving your money because if this happens....you will get a large tax increase...

And they will be travelling to Connecticut or Vermont, etc for health care to avoid the long lines. Well, actually only the bourgeois, sinec the for the working class it will be prohibitive, especially after paying all them damn taxes.....
This will eventually lead to a new law requiring the state to pay for people's travel and medical expenses in neighboring states when they go to receive their just and equal medical care.
 

djv

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I don't know if there will be long lines. Not sure why. Unless we believe 20% of the population of Mass did not go to see doctors before this law passed. And now there all going to start right away. Not sure this will happen. But as I said above answers are needed before health system really tanks. Many folks just can't pay $800 a month and up for family insurance plans. Chit that is more then some pay for a house a month. So there going with out. Guess what those of us still paying for insurance are paying for them already.
 

DOGS THAT BARK

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AR Will have to see more details on it--but bottom line is you don't get something for nothing and you are correct it will be passed to those that pay taxes. They will have 2 edged sword and I can't think of better place for model for this experiment.Business will pull out if penalized--insurance carriers will pull out if made to produce coverage not actuarially sound--gay population will migrate to the already "alternate lifestyle" friendly state.
Have made mention of this before--but when Hilliary had her national plan which was axed the great gov of Ky thought it was excellent idea and implemented most of her plan in ky.
Here is how it worked anyone regardless of their health paid same premium. If they were ky residence for 6 months they were entitled to insurance with no health questions--in fact an agent could write people in hospital. If you were perfectly healthy you paid same premium of person same age 100lbs over weight-smoker-with terminal cancer--with "unlimited benefits".
That made Ky only state with unlimited benefits for aids--and regardless where you lived you an had exhausted benefits you could move to ky an have unlimited benewfits in 6 months.
"Actuarial catastrophe"
Within 3 months of implementing every ins carrier pulled out of ky with exception of BC BS. --to make long story short when the politicians found out how bad they fcked up they repealed it.
We still have carriers that have not returned.
Something similiar happen in Alabama years ago in liabilty area of insurance. The courts and juries were awarding obscene amounts of claims and attorneys from many staeswere using Alabama as "preferred state" for litigation cases. Many Ins Co pulled out of state and Alabama got drilled on self insured plan they tried to implement.
Bottom line you can't dictate to business's or insurance co on how to operate--their object is to make money--if you subject them to mandates that are no win situations they will take their ball and go elsewhere.
 

djv

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However solutions are needed. Just tort reform is way short of the answer. It has to be included. But folks with high insurance cost witch seems to be growing fast. Are already paying the tax. States like Wisconsin with tort caps at $350000. Still have the high insurance cost. Family policies over $800 a month. And there companies they work for claim there paying 30% of the cost. That makes total cost around $1200 a month. I think folks paying that much might not mind taxes of $1000 more a year If it would save $300 or $400 a month in health cost. Thats a nice net gain. Now the bigger question is do we let the government try and run it. Or let the professionals from insurance companies. They may have to cut some profits to do it. So they may not offer. But I guess some business is better then nothing. In any case instead of looking for blame we need a good debate.
 

StevieD

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Something that DTB leaves out of his explanation of what happened in Kentucky is that Hillary's plan was for National Health Care. Of course if only one state choses to do something like that it leaves it open for the crooked, money grubbing, insurance execs to leave the state to be sure the plan fails. The last thing those greedy pricks want is a system that works and is fair to the working man.
 

AR182

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stevie....

imo there will a large beauracy with any type of universal health care....which opens up corruption.

if some people can get away with something that lines their pocket...they will....that's just human nature.....
 

AR182

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i think this hurts romney's chances as a republican candidate in 2008...

get ready guys.....tax hikes will come shortly...



Mass. Governor OKs Landmark Health Bill


Apr 12, 2:19 PM (ET)

By STEVE LeBLANC


BOSTON (AP) - Gov. Mitt Romney on Wednesday signed into law a landmark bill designed to guarantee virtually all Massachusetts residents have health insurance.

However, the governor vetoed a key portion of the bill - a $295-per-worker assessment on businesses that do not provide health insurance. Some critics have called that provision a tax on businesses.

The bill, intended to extend coverage to Massachusetts' estimated 550,000 uninsured, is being touted as a national model, thrusting the state to the forefront of the national debate about how to provide near-universal health care coverage without creating a single government-controlled system.

It's also a political coup for Romney as he weighs a potential run for the Republican presidential nomination in 2008. The bill could be a centerpiece of that campaign if Romney can credibly claim pushing through a groundbreaking health care reform package.

Romney used his line-item veto power to strike eight portions of the bill, most significantly the $295 fee. Administration officials say the fee could actually discourage registration for the new health program, since some employers might consider it cheaper to pay the fee than to insure workers.

"It's a very small feature of this bill. It's a very insignificant and unnecessary and, in some respects, counterproductive element of this bill," Romney had told The Associated Press in an interview on Tuesday. "It applies to a tiny number of employers, and it raises a very small amount of money relative to the scale of this entire proposal. So I don't think it's necessary."

Leaders of the heavily Democratic House and Senate said they would override any changes made by the governor.

"To change anything will disturb the delicate balance that made this law possible," House Speaker Salvatore DiMasi said in a statement. "Each and every element of this law is critical to accomplishing our intentions and goals."

In addition to the assessment for businesses, the bill would provide subsidies and sliding-scale premiums to get poor and low-income residents into health plans. Those deemed able to afford insurance but who still refuse would face increasing tax penalties.

Some critics say the requirement that everyone have insurance is an unacceptable expansion of government power.

The bill's cost was estimated at $316 million in the first year, and more than a $1 billion by the third year, with much of that money coming from federal reimbursements and existing state spending.
 
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