NCPA - National Center for Policy Analysis


May 5, 2006

Massachusetts's new universal health coverage law is being hailed as a model for what other states should do. But before you conclude that your state should enact a similar law, you might want to know how it would affect you. A careful reading of the Massachusetts law turns up surprises, says Betsy McCaughey, a former lieutenant governor of New York, who is chairman of the Committee to Reduce Infection Deaths.

Massachusetts aims to achieve universal coverage with a double mandate: All residents must have health coverage (Section 12) and all employers with more than 10 workers must assume ultimate financial responsibility if employees or their immediate family members need expensive medical care and can't pay for it (Sections 32, 44).

What is the impact on individuals?

  • The state will offer subsidies to help low income residents pay for coverage (Section 19), but most of the uninsured earn too much to be eligible.
  • An individual making $29,000 or more would probably have to pay the full cost or find a job that provides health insurance. Individual coverage costs about $3,600 in Massachusetts -- a hefty bill.
  • Moreover, under the new law, individuals purchasing their own insurance must buy HMO policies. Preferred provider plans (PPOs) -- which give you more ability to choose your own doctors and treatments -- are not allowed (Section 65).

It's one thing to criticize, says McCaughey, but there are alternatives to make health insurance more affordable. State legislators have pushed up prices by requiring policies to cover chiropractics, acupuncture and other services that are worthwhile -- if you can afford them. But mandating them is like passing a law that the only car you can buy is a Lexus, when all you can afford is a Ford Focus. People should be allowed to buy basic, high deductible insurance without costly extras.

Source: Betsy McCaughey, "Romneycare's Fine Print," Wall Street Journal, May 5, 2006.

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