Massachusetts Governor Signs Health Care Bill
Massachusetts Gov. Mitt Romney (R) on Wednesday signed into law a bill that aims to expand health care coverage to nearly all of the state's uninsured residents, but he vetoed several provisions, including a fee on certain businesses that do not provide health insurance, the Wall Street Journal reports (Bulkeley, Wall Street Journal, 4/13).
The bill, which was approved by the state Legislature on April 4, would 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% of the federal poverty level (California Healthline, 4/12).
Romney vetoed a provision calling for employers with 11 or more workers to provide health coverage or pay an annual fee of $295 per worker. The provision "was considered critical" to the legislation, the Los Angeles Times reports (Mehren, Los Angeles Times, 4/13).
Romney said the assessment on employers who do not provide insurance, which would yield about $48 million a year, was "not necessary for funding" the legislation, and the $295 assessment is "such a small figure" that "it doesn't have any significant incentive value" to encourage companies to provide coverage because it is much less than the actual cost of insurance.
Romney added, "There were many businesses that have been flooding my office with calls, as well as business associations, that were very concerned about it. There's not reason to put an extra charge on certain employers" (Belluck/Zezima, New York Times, 4/13). He said, "I am vetoing this section because it is not necessary to implement or finance health care reform" (Boston Globe, 4/13).
Regarding the bill's funding, Romney said, "I think what we can know is how much it's going to cost over the next three years. We've done the best human beings can do to carry out the full analysis and review."
The governor vetoed several other provisions, but the "vetoes promise to be more symbolic than meaningful," as the Legislature "passed the bill overwhelmingly" and is expected to override Romney's vetoes, according to the Boston Globe (Helman/Kowalczyk, Boston Globe, 4/13). Romney vetoed the following:
- A section that would extend dental and vision benefits to adult Medicaid beneficiaries and give beneficiaries who meet certain wellness goals discounts on premiums and copayments;
- A provision that would create a larger, revamped Public Health Council, which would advise the state public health commissioner and give new authority to the Massachusetts Hospital Association and other private organizations to appoint members to the council;
- A section allowing "special status aliens," including documented immigrants who have been in the U.S. fewer than five years or those who do not have permanent status, to receive Medicaid benefits regardless of the income of their sponsor;
- A provision that would require a member of the Massachusetts House and Senate to participate in negotiations with the federal government regarding special Medicaid funding; and
- A provision prohibiting the Romney administration from changing the financing, regulation of or operation of mental health benefits for Medicaid beneficiaries without first submitting its reasoning to the Legislature (Boston Globe, 4/13).
Romney added, "An achievement like this comes around once in a generation. Today, Massachusetts is leading the way with health insurance for everyone, without a government takeover and without raising taxes" (Pugh, Philadelphia Inquirer, 4/13). "This isn't 100% of what anyone in this room wanted. But the differences between us are small," he said, adding that the legislation would be "a big part of the legacy I will have personally for my four years of service as governor. But I have no way of telling if it's going to be a help or hindrance down the road."
State House Speaker Salvatore DiMasi (D), who had lobbied for a higher assessment on employers who do not provide health insurance, said, "Gov. Romney, if you change anything, you will disturb the delicate balance that made this law possible. Every element is critical to accomplishing this law's goals."
U.S. Sen. Edward Kennedy (D-Mass.) said to Romney, "You may well have fired the shot heard round the world on health care in America. I hope so" (New York Times, 4/13). He added, "With the signing of this landmark health reform bill, after so many years of false starts, our actions have finally matched our words, and we have lived up to our ideals. You have given Massachusetts just what the doctor ordered" (Los Angeles Times, 4/13).
State Senate President Robert Travaglini (D), who had opposed the employer fee, said that "never in my wildest dreams" did he envision being at a bill-signing for such historic legislation, adding, "We can all share the credit for this landmark legislation. But the biggest victory is for the people of Massachusetts, who will now have equal access to the most renowned health care in the world."
State Rep. Patricia Walrath (D), co-chair of the committee that crafted the final bill, said, "I don't understand how the governor can veto part of the bill and take full credit" (Helman/Kowalczyk, Boston Globe, 4/13).
Massachusetts Hospital Association President Ron Hollander said, "I think it is important that all the parts and all the parties stay together. The employer assessment is critical" (LeBlanc, AP/Long Island Newsday, 4/13).
John Holahan of the Urban Institute cautioned that, although the bill is funded for the next two years, the future of the legislation is less certain after that, adding, "There are a lot of things that have to happen right for there to be enough money."
Michael Widmer, president of the Massachusetts Taxpayers Foundation, said, "There are no significant traps. But numbers like this will never work out exactly. We think (that) it may well take some additional state dollars, but that it's likely to be a manageable amount" (Helman/Kowalczyk, Boston Globe, 4/13).
Alan Sager, a professor at Boston University's School of Public Health, said that the funding estimates for the legislation are insufficient, adding, "That's a reckless gamble. This bill could do great harm if it delegitimizes state reform efforts the way the Clinton plan, in '93-'94, delegitimized federal efforts" (Fahrenthold, Washington Post, 4/13).
Connecticut-based health insurer Aetna said that plan is "a common-sense approach to addressing the single-greatest strain on the health care system -- the uninsured" (Wall Street Journal, 4/13).
The Council for Affordable Health Insurance said, "We often seem to believe bigger is better. What Americans do not love is bigger government -- that is unless you listen to Gov. Mitt Romney and the Massachusetts Legislature" (Lambro, Washington Times, 4/13).
Michael Tanner, director of health and welfare studies for the Cato Institute, said the legislation has split the conservative movement, adding, "There's a group of big-government conservatives who believe you can use government power to achieve conservative ends. That puts Gov. Romney squarely in that camp. And the traditional small-government conservatives, I think, are going to be much more critical of this proposal" (Ebbert, Boston Globe, 4/13).
Several broadcast programs reported on reported on the bill's signing:
- APM's "Marketplace": The segment includes comments from Jeffrey Berry, chair of the department of political science at Tufts University; Jonathan Gruber, professor of economics at the Massachusetts Institute of Technology; and Sager (Palmer, "Marketplace," APM, 4/12). The complete segment is available online in RealPlayer.
- NPR's "News & Notes with Ed Gordon": The segment reports on the signing of the legislation (Gottbaum, "News & Notes with Ed Gordon," NPR, 4/13). The complete segment will be available online in RealPlayer after 4 p.m. ET.
- NPR's "News & Notes with Ed Gordon": The segment includes comments from Howard Koh, former health commissioner of Massachusetts and professor at the Harvard School of Public Health, and Ivan Walks, former chief health officer for Washington, D.C., and CEO of Ivan Walks and Associates, a consulting firm specializing in public health care policy (Chideya, "News & Notes with Ed Gordon," NPR, 4/13). The complete segment will be available online in RealPlayer after 4 p.m. ET.