Massachusetts Faces a Test on Health Care

NYT reported As the Democratic presidential candidates debate whether Americans should be forced to obtain health insurance, the people of Massachusetts are living the dilemma in real time.

This the plan both Hillary and Romney are proposing

A year after Massachusetts became the only state to require that individuals have health coverage, residents face deadlines to sign up or lose their personal tax exemption, worth $219 on next year’s state income tax returns. More than 200,000 previously uninsured residents have enrolled, but state officials estimate that at least that number, and perhaps twice as many, have not.

And since insurance will cost a lot more than $219 they may not.

Those managing the enrollment effort say it has exceeded expectations. In particular, state-subsidized insurance packages offered to low-income residents have been so popular that the program’s spending may exceed its budget by nearly $150 million.

That again is to be expected. The ones signing up are the subsidized ones, and even that subsidy is busting the budget.

But the reluctance of so many to enroll, along with the possible exemption of 60,000 residents who cannot afford premiums, has raised questions about whether even a mandate can guarantee truly universal coverage. Additional concerns have been generated by projections that the state’s insurers plan to raise rates 10 percent to 12 percent next year, twice this year’s national average.

This to be expected. If they have to appeal to people spending their own money, they keep prices low, but if it is a government mandate, there is no incentive to keeping prices low.

That would undercut the plan’s secondary goal of slowing the increase in health costs.