NCPA - National Center for Policy Analysis


June 24, 2005

Massachusetts residents who choose not to obtain health insurance would face tax penalties and even the garnishing of their wages under a proposal Gov. Mitt Romney (R) unveiled this week.

Romney says the "individual mandate" he is proposing, part of his broader plan to cover the roughly 500,000 people who are uninsured, would not cost the state any money. But some health care specialists say the approach might cost hundreds of millions of dollars more than state taxpayers currently provide for government health coverage.

Romney's plan would require all residents in Massachusetts to have some form of health insurance or agree to pay their medical bills out of their own pockets. No other state has such a requirement.

  • The Romney administration estimates that about 460,000 people, or 7 percent of the state's population, are uninsured.
  • Of those people, the administration calculates that 106,000 are eligible for Medicaid but not enrolled.
  • The governor says roughly 200,000 earn more than 300 percent of the federal poverty level, or $48,270 for a family of three, and will be able to afford the low-cost policies insurance companies will provide under his plan.
  • The remaining 150,000, who make too much for Medicaid but not enough to afford the discounted plans, would get state subsidies to help them pay for private insurance.

A Blue Cross-Blue Shield Foundation report raised questions about the approach endorsed by Romney. The authors could not put an exact price tag on Romney's proposal, but a similar plan to cover all the uninsured would cost an additional $700 million.

Source: Scott S. Greenberger, "Romney eyes penalties for those lacking insuranceCosts are key in health plan," Boston Globe, June 22, 2005; Mitt Romney, "Health-care reform gets a fair shake," Boston Herald, June 21, 2005; and Allison Cook, "Health Insurance Coverage and the Uninsured in Massachusetts," Blue Cross Blue Shield of Massachusetts, June 2005.

For Globe text:

For BCBS report:


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