Lawmakers Say Employer Mandate Key To Massachusetts Health Reform Law

Main Category: Health Insurance / Medical Insurance
Article Date: 24 Apr 2006 - 15:00 PDT

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State lawmakers on Tuesday at a Washington, D.C., forum sponsored by Families USA discussed the recently approved Massachusetts health insurance law, which includes mandates for individuals to have health insurance and for most businesses to offer it to their workers or face penalties, CQ HealthBeat reports. While the individual mandate has been "widely perceived as the key to the political breakthrough ... to adopt a plan for virtually universal health care coverage," the employer requirement is a "key part of the mix," according to CQ HealthBeat. In signing the legislation into law, Gov. Mitt Romney (R) vetoed a provision that would assess employers with 11 or more full-time workers $295 annually for each worker without coverage. Massachusetts House Speaker Salvatore DiMasi (D) said that Massachusetts lawmakers intend to override the veto. John McDonough, executive director of Health Care for All, said universal coverage will not happen without some form of mandate, adding that the "default" position of advocates of either an individual or employer mandate was to do nothing if their own approach did not prevail. He said DiMasi helped to push the bill through negotiations by proposing both an individual and employer mandate, instead of one or the other. McDonough said critics of the individual mandate supported the plan once the bill included the employer mandate. John Holohan, director of the health policy research center at the Urban Institute, said employer mandates do not work without individual mandates. DiMasi said in order for other states to pass similar laws, they must have both mandates and avoid new taxes. Phil Edmondson of Health Care Today -- which comprises various consumer, provider and union groups that seek to expand health coverage -- said businesses went along with the plan because they were tired of covering the cost of caring for the uninsured through cost-shifting. However, an unidentified analyst at the forum questioned whether employers would just pay the penalty to avoid the higher cost of providing health coverage (Reichard, CQ HealthBeat, 4/19).

A webcast of the Families USA forum is available online at kaisernetwork.org.

National Model?
The Baltimore Sun on Thursday looked at how the Massachusetts law might "not work as a direct model for other states" and how the plan "demonstrate[s] that a melding of conservative and 'progressive' ideas can bring political consensus," according to some of the plan's creators. It is too early to determine whether the plan is the start of a new consensus on how to provide coverage for the uninsured, according to Alan Weil, executive director of the National Academy for State Health Policy. He added that it is clear that the law's passage "has sparked renewed debate about what states can or cannot do." According to the Sun, "a number of questions remain about how the ... plan will work." In addition, "[r]egulations will be written over the next year ... that will spell out how to measure affordability and how much subsidy the state will provide" and "in turn, will determine how many people ultimately are covered and how much the plan will cost," the Sun reports (Salganik, Baltimore Sun, 4/20).

Opinion Pieces

• Fred Gluck, Baltimore Sun: "Massachusetts' bold new health plan paves a way to providing universal coverage, but doesn't really address the system's huge and relentlessly increasing costs," Gluck, presiding director of HCA, writes in a Sun opinion piece. According to Gluck, a "more comprehensive approach than the Massachusetts plan would mandate that all Americans be covered by private catastrophic high-deductible health care policies ... and ensure that they have cash to pay for routine care through health savings accounts." He writes, "Taking these steps would ensure health care for all, make the system infinitely less complex and much more user- and provider-friendly, and save hundreds of billions of wasted dollars that threaten the economic health of our nation and could be better spent on other pressing national needs" (Gluck, Baltimore Sun, 4/18).
  


• Benjamin Brewer, Wall Street Journal: The Massachusetts plan "designed to force all residents to get health insurance was a step in the right direction, but it doesn't go far enough," physician and Journal columnist Brewer writes. According to Brewer, "Under the Massachusetts approach, there will still be a maze of plans provided by any number of insurers," and the "multiplicity is the problem." He writes, "The solution that would really put health care dollars, and providers, to their best use would be a single-payer system -- namely, government-funded health coverage for all" (Brewer, Wall Street Journal, 4/18).
  

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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