Massachusetts Senator-elect Scott Brown has pledged to oppose health-care reform in Washington. But as a state senator in 2006 he voted in favor of an almost identical plan in Massachusetts that has since reduced the state's uninsured rate to the lowest in the nation. And he still supports the Massachusetts plan, reports the Washington Post.
“We have insurance here in Massachusetts," Brown said during the campaign. “I'm not going to be subsidizing…what other states have failed to do.” The state’s voters also overwhelmingly support the Massachusetts health reforms.
Here’s what you already have if you live in Massachusetts, but won’t get if you live anywhere else—unless Congress finally manages to pass its pending health-reform legislation.
A health insurance exchange. This is the signature reform of both the House and Senate bills. It is also a key feature of the Massachusetts plan. Bay Staters can go to the Massachusetts Health Connector (you can, too, if you want to see what you’re missing) and browse health care plans, all of which must meet certain coverage requirements that ensure that they’ll actually cover your medical needs. The Connector lets you compare the plans available to you side-by-side on premium costs, deductibles for various services, and prescription drug copays. The Congressional plans would have an almost identical exchange, with the added benefit of customer satisfaction information.
Guaranteed access to coverage and an individual mandate. Massachusetts requires you to have health insurance or pay a small fine, unless you can show that the cost would outstrip a certain percentage of your income. By having a lot of healthy people in the risk pool, the cost of caring for sick people gets spread over a wider base and makes coverage more affordable for everybody. It also makes it possible to bar insurance companies from turning people down on the basis of pre-existing conditions. With no mandate, and if people could get insurance whenever they wanted no matter what their state of health, many people could game the system by waiting until they got sick to sign up for insurance. That would quickly drive premiums sky-high.
Employer contribution. In Massachusetts, all employers with 11 or more employees are required to provide a certain level of coverage, or pay into a statewide kitty. The Congressional plans have other mechanisms encouraging employers to provide health insurance. It’s another reason why Massachusetts has been able to cut down on its uninsured. If similar rules were enacted nationwide this would help reverse the trend of employers reducing health coverage.
Medicaid expansion. Massachusetts expanded its Medicaid program so more moderate-income residents could qualify. The federal reforms would also expand Medicaid to about 15 million additional people.
And that’s not all. Massachusetts introduced new subsidies for people who make too much to qualify for Medicaid, but not enough to afford market-rate insurance. The Congressional bill would also provide federal tax credits so families can buy insurance from the exchange—even families in Massachusetts. And the House would increase choice by providing a public option, while the Senate version adds at least one non-profit option overseen by the federal government.
The Massachusetts reforms have brought the percentage of the state’s uninsured down to about 2.5 percent; the nationwide rate is more than 15 percent. Brown said he didn’t want Massachusetts to subsidize other states' reform. But Massachusetts used federal Medicare funds to establish their new system. And they’d get millions more federal dollars if national reforms were enacted.
Massachusetts has done a lot to improve its health care system. But as Americans, we’re all in this together. If we want to cover the nation’s uninsured and tackle run-away health costs, we’ll need nationwide reform.
—Kevin McCarthy, associate editor
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