Experts Question Compulsory Health Coverage Plan Proposed by Massachusetts Governor

A proposal announced on Tuesday by Massachusetts Gov. Mitt Romney (R) that would make health insurance compulsory "might cost hundreds of millions of dollars more than state taxpayers currently provide for government health coverage," according to some health care experts, the Boston Globe reports. Romney on Tuesday said that he would finance the proposal with funds currently used to provide health coverage for uninsured state residents. However, a report released on Tuesday by the Blue Cross Blue Shield of Massachusetts Foundation said that a similar proposal would cost an additional $700 million (Greenberger, Boston Globe, 6/22).

The Romney proposal would:

Enroll in Medicaid 106,000 eligible state residents who are not currently enrolled in the program;

Establish Safety Net Care, a program offered by private health insurers that would provide comprehensive health coverage for about 150,000 uninsured state residents with annual incomes between one and three times the federal poverty level;

Expand health coverage to about 200,000 uninsured middle-income state residents through Commonwealth Care, which Romney proposed earlier this year (California Healthline, 6/21);

Request that uninsured state residents enroll in one of these programs when they seek care;

Cover the health care costs of state residents who fail to obtain health insurance through the cancellation of the personal tax exemption on their state income taxes, the placement of some or all of their state income tax refunds in a "personal health care spending account" or the removal of funds from their paychecks (Boston Globe, 6/22); and

Offer incentives to employers to provide health insurance to workers and mandate that employers cannot drop coverage for workers (California Healthline, 6/21).

Romney Comments

Romney said that the proposal would prevent "free riding," in which "an individual says: 'I'm not going to pay even though I can afford it. I'm not going to get insurance, even though I can afford it. I'm instead going to show up and make the taxpayers pay for me.'" Romney added, "It's the ultimate conservative idea, which is that people have responsibility for their own care, and they don't look to government to take care of them if they can afford to take care of themselves."

Reaction

Linda Blumberg, an economist at the Urban Institute and a co-author of the BCBSM Foundation report, said, "If you're going to provide comprehensive benefits at an affordable level, I don't believe you can do it without any new spending."

However, Philip Johnston, chair of the BCBSM Foundation and the Massachusetts Democratic Party, said that he was "delighted that ... Romney is serious about providing affordable health care to all citizens of this state."

Sen. Edward Kennedy (D-Mass.) called the Romney proposal "a healthy step forward," but he added that "details of the benefits offered and the level of cost sharing individuals will face are crucial to understanding this proposal."

State Senate President Robert Travaglini (D) said that he will not "rule out" the proposal, adding, "Nothing is going to be dismissed outright; this is too important of an issue."

Michael Cannon of the Cato Institute said, "All around us, we see signs that government mandates and heavy-handed, command-and-control models of providing health care don't work and people are abandoning those, and yet the governor seems to be running toward them."

Karen Davis, president of the Commonwealth Fund, said, "The sticking point has always been the affordability of coverage. It's one thing to tell people they have to buy it. If they can't afford it, what do you do? Fine them? Put them in jail?" (Boston Globe, 6/22).

Editorials

Boston Globe: The Romney proposal would improve the state's "creaky" uncompensated care pool, which helps cover the cost of health care for uninsured state residents, according to a Globe editorial. However, the proposal likely will require as much as $1.2 billion in additional funds, despite a claim by Romney that he can finance the proposal with funds currently used to provide health coverage for uninsured state residents, the editorial states (Boston Globe, 6/22).

Boston Herald: The proposal "has real potential for turning health care in a new direction," a Herald editorial states. However, "we would be less skeptical of the success of such a program if the state under the Romney administration had a better track record of using the tools and the programs it already has," according to the editorial (Boston Herald, 6/22).

Opinion Pieces

Ann Donlan, Boston Herald: "For once, there was little partisan griping" after Romney announced the proposal, Donlan writes in a Herald opinion piece. She adds that Kennedy "praised Romney's proposal," and Johnston "took an uncharacteristically conciliatory tone" toward the proposal (Donlan, Boston Herald, 6/22).

Jay Fitzgerald, Boston Herald: Romney has "launched a revolution over health care," Fitzgerald writes in a Herald opinion piece. He adds that "whether Romney can piece together a coalition to topple the largely employer- and government-paid system is another matter" (Fitzgerald, Boston Herald, 6/22).

Andrew Miga, Boston Herald: "Romney's political resume is long on ambition but short on accomplishment -- a potentially fatal mix for anyone seeking to win the White House," Miga writes in a Herald opinion piece. "That's why Romney ... is suddenly trumpeting a new universal health care plan," Miga writes, adding, "But it's doubtful Romney's new health care proposal will flesh out his policy credentials -- or boost his national profile" (Miga, Boston Herald, 6/22).

This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.