Is this legal???

If this passes I think there will be a lot of unintended consequences like it being cheaper to get fined than insured employees and small business' going under.

BOSTON - Lawmakers overwhelmingly approved a bill Tuesday that would make Massachusetts the first state to require that all its citizens have some form of health insurance.

The plan — approved just 24 hours after the final details were released — would use a combination of financial incentives and penalties to dramatically expand access to health care over the next three years and extend coverage to the state's estimated 500,000 uninsured.

If all goes as planned, poor people will be offered free or heavily subsidized coverage; those who can afford insurance but refuse to get it will face increasing tax penalties until they obtain coverage; and those already insured will see a modest drop in their premiums.

The measure does not call for new taxes but would require businesses that do not offer insurance to pay a $295 annual fee per employee.

The cost was put at $316 million in the first year, and more than a $1 billion by the third year, with much of that money coming from federal reimbursements and existing state spending, officials said.

The House approved the bill on a 154-2 vote. The Senate endorsed it 37-0.

A final procedural vote is needed in both chambers of the Democratic-controlled legislature before the bill can head to the desk of Gov. Mitt Romney, a potential Republican candidate for president in 2008.

Romney has expressed support for the measure but has not said whether he will sign it.

"It's only fitting that Massachusetts would set forward and produce the most comprehensive, all-encompassing health care reform bill in the country," said House Speaker Salvatore DiMasi, a Democrat. "Do we know whether this is perfect or not? No, because it's never been done before."

The only other state to come close to the Massachusetts plan is Maine, which passed a law in 2003 to dramatically expand health care. That plan relies largely on voluntary compliance.

"What Massachusetts is doing, who they are covering, how they're crafting it, especially the individual requirement, that's all unique," said Laura Tobler, a health policy analyst for the National Conference of State Legislatures.

The plan hinges in part on two key sections: the $295-per-employee business assessment and a so-called "individual mandate," requiring every citizen who can afford it to obtain health insurance or face increasing tax penalties.

Liberals typically support employer mandates, while conservatives generally back individual responsibility.

"The novelty of what's happened in this building is that instead of saying, `Let's do neither,' leaders are saying, `Let's do both,'" said John McDonough of Health Care for All. "This will have a ripple effect across the country."

The state's poorest — single adults making $9,500 or less a year — will have access to health coverage with no premiums or deductibles.

Those living at up to 300 percent of the federal poverty level, or about $48,000 for a family of three, will be able to get health coverage on a sliding scale, also with no deductibles.

The vast majority of Massachusetts residents who are already insured could see a modest easing of their premiums.

Individuals deemed able but unwilling to purchase health care could face fines of more than $1,000 a year by the state if they don't get insurance.

Romney pushed vigorously for the individual mandate and called the legislation "something historic, truly landmark, a once-in-a-generation opportunity."

One goal of the bill is to protect $385 million pledged by the federal government over each of the next two years if the state can show it is on a path to reducing its number of uninsured.

The U.S. Department of Health and Human Services has threatened to withhold the money if the state does not have a plan up and running by July 1.

 

i predict a lot of sick people moving to ma if this passes. i know i would if i needed something like a heart transplant and had no insurance.

 

Sure it's legal, just like mandatory auto insurance is legal. In this case they don't even punish people or put them in jail but instead they just levy extra taxes. What can be more legal than states collecting taxes.

Personally I am not particularly thrilled with this version of the bill but it's a small step in the right direciton - Universal Coverage.

 

it's not the same thing, mandatory auto insurance is there to protect the other driver, not you.

In all likelihood it will be cheaper for small business owners to pay the fine and cancel their insurance plans for their employees and transfer the cost to the employee and the state.

 

People will see a modest drop in premiums under this plan, now that is really funny, haha.

 

small correction: laws mandating auto insurance are there to protect the insurance companies, not you.

this is a feature you may find curiously common to most nanny-state, "for your own good"-type laws.

 

Still it shows that states have legal authority to mandate that residents buy insurance.

Good, especially transfering the cost to the state, just like it works in all developed civilized countries. The sooner that happens the better off financially and health-wise we are all going to be.

 

Isn't it common knowledge that the state is usually incredibly inefficient with money, and innefectual in getting services to people?

 

I'm all for it, especially since I dont' live in Mass.

Let them be the guinnea pig. Maybe it works but after mass migration it will probably collapse.

 

The Organization of Economic Cooperation and Development studied the health expenses of all member countries - 29 in all including the United States. As a percentage of GDP basis, the US spends between 34% and 75% more as a percentage of GDP than countries that rely primarily on public funds to provide health service. Yet the US healthcare system does not cover 15-20% of the population and the US benefits are below median for all OECD countries.
http://www.oecd.org/document/16/0,2340,en_2649_37407_2085200_1_1_1_37407,00.html


A recent study in the International Journal of Health Services found that in 2003, administration costs in the US health care system ate up about $400bn, or about 25% of total health care spending.

By comparison, national health care systems incur administrative costs of a few percent of total health expenditures: according to the NEJM study Canada's national health insurance system spends just 1.3% on overhead, and the US's Medicare and Medicaid programs have administrative costs of between 2-5%.