Mass. mandatory healthcare coverage becomes law among sea of praise and criticism

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Lawmakers in Massachusetts last week approved a bill – and Gov. Mitt Romney signed it into law yesterday – that will provide nearly universal health insurance coverage for its citizens that is essentially mandatory. This topic has been met with enough media attention and praise, but also considerable criticism from all sides.

By far the most controversial component of the bill was a penalty that would hit any employer of 11 or more people that does not offer a health plan. Such companies would see a $295 annual fee per uninsured worker. However, Romney vetoed, as expected, this portion of the plan. It would have generated $48 million each year to pay for coverage for the uninsured. In another twist, it is likely that the state’s legislature will be able to override the veto, according to the Boston Globe.

The law will now require all residents to purchase health insurance by July 1, 2007, and would create a low-cost, state-subsidized health insurance program for residents with incomes up to 300 percent of the federal poverty level.

Otherwise, those who qualify for coverage but elect not to have it would be penalized, while those with coverage would see a small deduction in their premiums. All citizens without access to insurance would be covered, either at no cost or at very low cost, depending on circumstance.

“It’s [$295 annual fee] a very small feature of this bill. It’s a very insignificant and unnecessary and, in some respects, counterproductive element of this bill,” said Romney regarding his plan to veto the item, the AP reports. Romney added, “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.”

Romney also vetoed other provisions, such as: a section that would extend dental and vision benefits for adult Medicaid beneficiaries; a provision to create a larger, renovated Public Health Council; a provision for “special status aliens” to receive Medicaid benefits and a stipulation prohibiting the Romney administration from changing the financing, regulation of or operation of mental health benefits for Medicaid beneficiaries without first submitting them to the Legislature.

While politicians are haggling, others have criticized the bill for not taking on healthcare costs, or have questioned its overall viability. For instance, an opinion piece this week in Monday’s USA Today criticized the plan’s reliance on ‘individual mandate’ stating that “Starting in July 2007, residents must purchase a state-approved healthcare policy or they will be fined. This will be expensive to enforce. This mandate also is sure to fail to provide universal coverage. Although many states require the purchase of auto insurance, 14 percent of drivers are still on the road without insurance.”

Others feel the plan is ambitious and important, but, yet, not ambitious enough to get to the core of the problem. A columnist opined in the New York Times Wednesday that the plan “will not reduce misdiagnosis or wasteful medical spending, because hospitals will still be paid for what they do rather than how well they do it.”