Legalectric

Health Care — Massachusetts has a start

April 5th, 2006

I’m on my second sick day here, with my little bro’s lilt in my brain, “I feel shitty, oh so shitty, I feel shitty and witty and gaaaaaaaay!” and hope I get better soon so I can change my tape loop. Anyway, the Times today has a report on the Massachusetts legislation on health care.

Massachusetts sets health care plan for nearly all

A few snippets:

The Massachusetts bill creates a sliding scale of affordability ranging from people who can afford insurance outright to those who cannot afford it at all. About 215,000 people will be covered by allowing individuals and businesses with 50 or fewer employees to buy insurance with pretax dollars, and by giving insurance companies incentives to offer stripped-down plans at lower cost. Lower-cost basic plans will be available to people ages 19 to 26.

Subsidies for other private plans will be available for people with incomes at or below 300 percent of the poverty level. Children in those families will be eligible for free coverage through Medicaid, an expansion of the current system.
…

Mr. Romney pushed the idea of the “individual mandate,” requiring people who can afford insurance to buy it. The bill makes it possible for employers to enable many of those people to use pretax dollars, saving them 25 percent or more. Individuals who fail to get health insurance by July 2007 will first lose their personal exemption on their state taxes. In subsequent years, they would have to pay a penalty that could be as high as half of what an affordable health care premium would cost.Eric Fehrnstrom, the governor’s communications director, said that for those people with incomes above 300 percent of poverty, “our assumption was that these would be mostly single mothers who just did not have the wherewithal to get insurance. It turned out it was mostly young males. In some cases they are making very attractive salaries. These are people who just don’t imagine themselves needing care, but of course when they break a leg when they’re out bungee jumping they go to the hospital and we end up paying for their care anyway.”

Now color me skeptical, because the state’s motivation was that the federal government had threatened to cut Medicaid funding unless more of its people had health insurance. So the focus here is not in providing health care, but in getting people to buy health insurance, which I object to! I struggle with our societal expectations about health care — working at Hennepin County Medical Center taught me more about our health care system than I want to know — the up side of it was that I observed medical training at all levels and I have a lot of confidence in the process, another up side is that if I were really sick or injured, that’s where I’d want to go. But our notion of private health care, the necessity of having “our” doctor, isn’t something I ascribe to because anyone can treat a sinus problem or pull a tooth, and too many plans do not cover the types of things where that is important, i.e., midwifery, mental-health — it’s been too long since Wellstone was trying to achieve mental-health coverage parity, and we’re no closer and so many physical chronic ailments are “all in your head.”

Anyway, what is heartening is that they provide coverage subsidies for those up to 300% of poverty. What’s that? Here are the 2006 Federal Poverty Guidelines.

2006 poverty guidelines.jpg