Massachusetts health care law inspires federal overhaul

With the Capitol in the background, Republican presidential candidate, former Massachusetts Gov. Mitt Romney speaks about the Supreme Court's health care ruling, Thursday, June 28, 2012, in Washington. (AP Photo/Charles Dharapak)

With the Capitol in the background, Republican presidential candidate, former Massachusetts Gov. Mitt Romney speaks about the Supreme Court's health care ruling, Thursday, June 28, 2012, in Washington. (AP Photo/Charles Dharapak)

BOSTON — Massachusetts has the nation's highest rate of residents with health insurance. Visits to emergency rooms are beginning to ease. More residents are getting cancer screenings and more women are making prenatal doctors' visits.

Still, one of the biggest challenges for the state lies ahead: reining in spiraling costs.

Six years after Gov. Mitt Romney signed the nation's most ambitious health care law — one that would lay the groundwork for his presidential opponent's national version — supporters say the Massachusetts law holds promise for the long-term success of Barack Obama's plan.

Like the federal law it inspired, the Massachusetts law has multiple goals, among them expanding the number of insured residents, reducing emergency room visits, penalizing those who can afford coverage but opt to remain uninsured, and requiring employers to offer coverage or pay a fine.

Supporters of the Massachusetts experiment are quick to point out its successes.

An additional 400,000 individuals have gained insurance since 2006, meaning about 98 percent of residents have coverage.

A recent study by the Blue Cross Blue Shield of Massachusetts Foundation found that between 2006 and 2010, the use of emergency rooms for non-emergency reasons fell nearly 4 percent. That was a key goal of the law, since using emergency rooms for routine care is far more expensive than visiting a doctor.

State health officials also point to what they say are increases in mammograms, colon cancer screenings and prenatal care visits and a 150,000-person reduction in the number of smokers after the state expanded coverage for smoking cessation programs.

"Since Gov. Romney signed health care reform here in Massachusetts, more private companies are offering health care to their employees, fewer people are getting primary care in an expensive emergency room setting, and hundreds of thousands of our friends and neighbors have access to care," said Gov. Deval Patrick, a Democrat and co-chairman of Obama's re-election committee.

Another reason the law remains popular may be that so many Massachusetts residents receive insurance through work and have been largely untouched by its penalties. The Blue Cross Blue Shield study found 68 percent of non-elderly adults received coverage through their employers in 2010, up from about 64 percent in 2006.

The study also found no evidence to support one fear lawmakers had when they approved the law — that employers or workers might drop coverage because of the availability of public coverage.

Another indication of the law's acceptance in Massachusetts is the reduction in the number of those assessed a tax penalty for failing to have insurance despite being able to afford it. In 2010, 44,000 Massachusetts tax filers were assessed the penalty under the "individual mandate." That's a drop from the 67,000 people required to pay the penalty in 2007, the first year it was assessed.

In 2010, the highest penalty was $93 a month, or $1,116 a year. In 2012, the highest penalty increased to $105 a month, or $1,260 a year.

Massachusetts is the only state with an individual mandate, although the Supreme Court last week upheld the constitutionality of a similar mandate in the federal law.

Despite the penalty, most polls place support for the initiative at more than 60 percent, about double the approval rate for the federal health care law.

Supporters say there's a lesson there too. The more people begin to understand the benefits of the federal law, they say, the more support for the federal law should increase.

"The first lesson is that you can meet the goals we set out in Massachusetts, you can cover the majority of the uninsured and fix the broken market" for health care, said Jonathan Gruber, who helped craft both the state law and the federal law as an adviser to Romney and Obama.

"And you can do so with broad public support," Gruber said. "Based on what we've seen in Massachusetts, people like this."

There are other indications of improving access to care in Massachusetts since the law was approved in 2006.

Residents are more likely to have a place they usually go when they are sick or need advice (up 4.7 percent), more likely to have had a preventive care visit (up 5.9 percent), more likely to have had multiple doctor visits (up 5 percent) and more likely to have had a dental visit (up 5 percent), the Blue Cross Blue Shield report found.

The charge that the 2006 law has been a "budget-buster" in Massachusetts has also been challenged.

A recent study by the business-backed Massachusetts Taxpayers Foundation found that during the five full fiscal years since it was implemented, the law has cost the state an additional $91 million a year after federal reimbursements — well within initial projections.

The idea of exporting Massachusetts' law to the rest of the nation has its critics too.

Josh Archambault, health care policy director for the Pioneer Institute, a conservative-leaning Boston-based think tank, said a narrower approach would be better.

"There are many unintended consequences when Washington tries to design a policy that meets the very different needs of states as diverse as Massachusetts and, say, New Mexico," he said. "We need some specific federal actions to increase access to affordable health care, but the (federal law) went too far."

There's also at least one big cautionary note: Massachusetts still struggles to slow the spiraling cost of health care for residents.

This year both the Massachusetts House and Senate have approved bills aimed at trimming projected health care costs in the state by $150 billion to $160 billion over the next 15 years. A committee is hoping to iron out the differences between the two bills before the end of the formal session July 31.

Gruber said that while expanding coverage is easier than controlling costs, the cost question shouldn't be used as a reason not to expand coverage.

Gruber, who wrote a comic book called "Health Care Reform: What It Is, Why It's Necessary, How It Works" to help explain the federal law, likened health care expansion to a baby in its crib.

"We're going to have to crawl before we can walk and run," he said. "To say the bill failed (because it didn't include cost controls) is to say we need to keep the baby penned up until it can run."

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Comments » 8

Mayor_McCheese writes:

A very clear recitation of the facts as they apply to Massachusetts. A worthy read.

Ruger writes:

in response to GorchFock:

(This comment was removed by the site staff.)

Great leaders take responsibility for their own failed policies, that is not how Obama does things.

Romney said that this is a State issue, not a federal one.

How do you feel about Obama's promise to the middle Class that he wouldn't raise taxes? You know that was a big lie, right?

http://articles.latimes.com/2012/jun/...

“I’m going to get rid of the cloud of Obamacare and get us back to personal responsibility and states’ rights as it relates to health care,” said Romney, who has defended the plan he imposed in Massachusetts but has also said that states, and not the federal government, should regulate healthcare coverage.

http://www.humanevents.com/2012/06/30...

nearly 75% of Obamacare costs will fall on the backs of those Americans making less than $120,000 a year.

“It’s a big punch in the stomach to middle class families.”

August8 writes:

A Massachusetts Decision years ago, no one gives a darn about that now It's the worst man in history must be drug from the WH Hurry before we all suffer greatly

1Paradiselost writes:

in response to August8:

A Massachusetts Decision years ago, no one gives a darn about that now It's the worst man in history must be drug from the WH Hurry before we all suffer greatly

"must be drug from the WH"

Where did you go to school.. Redneck Elementary?

August8 writes:

Yes, Red-Neck Elementarty, Jr High as well as Senior High and collage.Oh, streight A's too !!!
Where did you go to school in Mass. and why are you not there with the Crat's?
The Country is in a depression and people, us red-necks, are suffering. This Cat has made this much worse and now wants to add another entitlement so we can pay for someone elses heath care. Do it you want Crat but the majority of American's are ready to fight, something I know your not up to.

Sparky100 writes:

Romney realized that mandatory health care was wrong and was man enough to admit it. True, MA companies are covering more employees, but at what cost, extremely high premiums', all of which comes directly out of their employee's wages. Insurance companies are holding employers hostage because they know they need to supply coverage to their employees. How did the insurance mandate adjust costs, it RAISED them, that is from personal experience. Will it work on a national level, no way, it will only raise premiums. A real "Great" man will admit when he is wrong and learn from those mistakes and not blame it on others. In regards to the Romney commercial about being last in job creation and highest in debt, all true at the start of his administration, research his final numbers, you will be surprised, and he didn't blame on the previous governor.

1Paradiselost writes:

in response to August8:

Yes, Red-Neck Elementarty, Jr High as well as Senior High and collage.Oh, streight A's too !!!
Where did you go to school in Mass. and why are you not there with the Crat's?
The Country is in a depression and people, us red-necks, are suffering. This Cat has made this much worse and now wants to add another entitlement so we can pay for someone elses heath care. Do it you want Crat but the majority of American's are ready to fight, something I know your not up to.

The Republican's rely on people like you who are uneducated who vote against their own best interests.

Is it in your best interest to support a party that has blocked any type jobs bills in the past 2 years? Is it in your best interest to give tax breaks to the rich. Oh yea excuse me "Job Creators". They have had the same tax breaks since 2003, where are the jobs August?

You wonder why your suffering? You keep voting for people who are so firm in there resolve they are willing to end America as we know it, while they wrap themselves in the flag.

We all love America but life is a compromise! You can't be the party of NO and expect to get the American economy moving forward, do you?

I'm a Republican, but I can't support anyone who is willing to take down the American people like yourself. Your suffering is your own fault due to uninformed decisions. If one was smart they would modify their behavior to stop making the same mistakes over and cover again?

Oh BTW read this... your boy is a tax dodger too, who should be put in jail. Remember life is choosing the lesser of two evils. Your not married to Miss America are you?

http://xfinity.comcast.net/articles/n...

WhiskeyTangoFoxtrot writes:

in response to 1Paradiselost:

The Republican's rely on people like you who are uneducated who vote against their own best interests.

Is it in your best interest to support a party that has blocked any type jobs bills in the past 2 years? Is it in your best interest to give tax breaks to the rich. Oh yea excuse me "Job Creators". They have had the same tax breaks since 2003, where are the jobs August?

You wonder why your suffering? You keep voting for people who are so firm in there resolve they are willing to end America as we know it, while they wrap themselves in the flag.

We all love America but life is a compromise! You can't be the party of NO and expect to get the American economy moving forward, do you?

I'm a Republican, but I can't support anyone who is willing to take down the American people like yourself. Your suffering is your own fault due to uninformed decisions. If one was smart they would modify their behavior to stop making the same mistakes over and cover again?

Oh BTW read this... your boy is a tax dodger too, who should be put in jail. Remember life is choosing the lesser of two evils. Your not married to Miss America are you?

http://xfinity.comcast.net/articles/n...

Well said! Insanity: doing the same thing over and over again and expecting different results.
Albert Einstein

Keep fighting about Obamacare while the leaders you can't wait to vote for are all on the same page, and laughing at your stupidity.

Romney won't repeal Obamacare. Nor will anyone from the right or left. They are all on the same page.

From a time when people had balls..1776-
That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, --That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.

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