State Law Sparks Rise in Health Coverage

In the two years since a Massachusetts mandatory health-care law went into effect almost half a million people have obtained health insurance, resulting in nearly all state residents being covered and making Massachusetts the first U.S. state with near-universal health insurance, say state officials. 
 
"To have insured nearly a half-million people in less than two years is nothing short of remarkable," said Gov. Deval Patrick.  
 
Health insurance is mandatory under the law through an "individual mandate" that requires virtually everyone to have health insurance or face tax penalties. Health insurance is free for those who earn less than the federal poverty level of $9,800 a year. Subsidized plans are available for people who earn up to three times the poverty level. 
 
Ninety-three percent of Massachusetts residents, or 5.9 million people, had health insurance according to a 2004 survey. Of the 460,000 uninsured, about 40 percent earned more than the federal poverty level. There was no estimate on how many people remain uninsured. 
 
Although the law is being viewed as a possible national model as traditional employer-based coverage shrinks nationwide, it is under fire with some health policy experts who question whether it can be sustained because it depends heavily in the long term on slowing growth in health-care costs, a prospect that some doubt will happen in face of continued cost increases in recent years. 
 
More than 250 members of a physician’s advocacy group signed a letter this year that said public funds for care of the poor that previously flowed directly to hospitals and clinics now flowed through insurers with higher administrative costs. 
 
"While patients, the state and safety net providers struggle, private insurers have prospered under the new law, and the costs of bureaucracy have risen," said the letter. 

Published on August 21, 2008