Three years ago, Massachusetts was one of the first states to dip a toe into healthcare reform. It was actually a Republican governor, Mitt Romney, who signed the bill into law. The Massachusetts health insurance mandate requires everyone in the state has to be insured, similar to several proposals in Congress. While the government offers subsidies to those who are ineligible for existing state programs but still unable to afford individual health insurance, people who are able to buy insurance but choose not to will be penalized. The Obama administration shares Massachusetts’ stated goal of expanding health coverage to as many people as possible, but has paid surprisingly little public attention to their results.
How has their experiment worked? In terms of insuring more Americans, the state has seen success. The Washington Post reports that while 85% of the nation’s residents have health insurance, 97% of Mass. residents are insured. However, costs have continued to increase and some services (such as dental and hospice care for legal immigrants) have been cut. Supporters of a nationwide public option point to Massachusetts as an example of why it’s necessary: the state government-run insurance programs (such as Commonwealth Care) spend less than similar programs nationally, but for-profit insurers are set to increase their premiums by 10% next year.
Others, such as Romney, believe that the state’s success in getting nearly all of its residents insured without a public option proves that it’s unneeded in any health care reform. Coordinated care, which reimburses physicians based on the outcomes of their patients as opposed to how many procedures they perform, is what he suggests to control costs. Unlike the current health insurance system, coordinated care would discourage doctors from performing needless tests, while encouraging care that prevents future conditions that are more expensive to treat.
(Image: Norman B. Leventhal Map Center at the BPL under CC 2.0)