MA may be first state to require health insurance

[riona]

http://www.tbo.com/news/nationworld/MGB32RT2NLE.html

"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.

[Warpy]

1. Yeah? What are they going to do about the WAGES a person

has to earn to be able to afford health insurance, especially a person over 40 and/or with chronic health issues?

This is a rich man's scheme. I'm glad I don't live there any more.

[wildflower]

2. I'd be interested to learn more about this part:

"If all goes as planned, poor people will be offered free or heavily subsidized coverage;"

I wonder how that will work.

wildflower

[Warpy]

3. First, they look at your gross pay

Then they decide you could pay the full price. They don't bother looking at what you're being gouged for rent or anything else.

I've seen plans like this one before. Their definition of poor is DESTITUTE.

Those firetrap triple deckers in Mattapan are going to look a whole lot more attractive to people in the Back Bay who suddenly find themselves with a huge insurance bill and no way to pay it and rent, too.

[sui generis]

6. 300 dollars a year.

I don't think $25/month is unreasonable. I just can't get excited about knocking the program for that. If somebody is SO POOR they can't afford $25 a month but not already "destitute" then I have other questions to ask.

Come on - let's hear some solutions in addition to complaints.

[no name no slogan]

8. Loosen Medicaid eligibility requirements

Those who are uninsured tend to be those who either make to much to qualify for Medicaid or work for companies that cannot afford to provide medical coverage for their employees.

We already have a system that covers the medical needs of poor people: it's called Medicaid. The bureaucracy is already there, and the program already works. All we need to do is expand eligibility to those who cannot afford to pay for private coverage.

But that would be too easy. We should just create another quasi-private bureaucracy that answers to nobody and has no negotiating power, instead. At least that's what purveyors of "free market healthcare" would want us to do.

[sui generis]

9. that's a solution

but I still would want EVERYONE to have access to the same insurer at the same price. That means much more than just loosening requirements.

Personally, "who can afford to" is in the eye of the beholder, as you know. An uninsured secretary making 35K a year can't afford to pay for her kids chronic condition meds and treatments even though she might just barely be able to afford his annual checkup and maybe one prescription of antibiotics a year.

It has to be available to everyone, not just "the poor", or you really won't have any negotiation leverage with pharma.

[sui generis]

4. it's right hearted but wrong minded.

Two things need to happen in conjunction for this to work.

1. The state MUST negotiate healthcare COSTS with healthcare providers, specialists, and pharmacy (formulary) in a meaningful way. This needs to be law - a forced cap on pharma, and a rational formulary.

2. Just like unemployment and social security, the employer should pay the $300 dollar annual cost per employee. If the employee is unemployed for more than a year following termination of employer coverage they've gotta come up with the money themselves, kind of like COBRA, except without a termination date until employed again.

3. Businesses get a tax credit

4. Self employed pay 1.5 or 2X, offset by other tax credits on their business income.

Some variation of this, plus reasonable co-pays.

Let's discuss why it wouldn't work now. Yup. EXISTING insurers have a right to profit from you greater than your right to healthcare coverage.

The risk pool actuary game they play to allegedly give low risk members the best premium is not designed to cover their losses by reassigning risk any more so much as to guarantee their profits and growth to investors, at the cost of your health. It has no place in modern society - we need equal and fair coverage regardless of your health status.

If we want affordable universal healthcare coverage, we're going to have to throw the dirt out with the bathwater. Who's with me! Let's storm the bastille. The government must become, HAS TO become the collections arm of a government contract private insurer for universal health coverage, even if it hurts the health insurance industry's profits.

[no name no slogan]

5. Look at the MN and VT models

both states offer subsidized medical coverage to the working poor (provided by private insurers/HMOs), and both have nearly universal coverage-- but neither state has COMPULSIVE coverage.

Requiring coverage is NOT Universal healthcare. It merely criminalizes the working poor for being poor.

[Finder]

7. It would also hurt the self-employed and small businesses. n/t