Romney Plan Would Require All to Buy Health Insurance …Or Else

Massachusetts Gov. Mitt Romney would require every person in the state to have health insurance under his plan for universal health coverage.

The governor described the plan at a health care conference at the John F. Kennedy Library and Museum. The announcement was the first time he detailed his “Safety Net Care” proposal, which completes his three-part health care reform package.

Romney’s announcement continued growing momentum to reform health care and create universal health coverage. The state Senate has also proposed health care legislation, and the nonprofit group Health Care for All has a reform plan as well.

Romney said his Safety Net plan would cost $922 million annually, the same as the existing free care pool, which now pays for care for people without any insurance.

Romney’s plan also relies on enrolling 106,000 people in Medicaid who are eligible but aren’t currently enrolled. That would cost about $400 million, split between the state and the federal government.

The Safety Net plan is geared toward the roughly 150,000 state residents who make too much money to qualify for Medicaid and too little to buy private insurance. Romney said many of these people are young, male and single, and most work.

“This is a group of people who are eminently insurable,” he said.

The plan would require people to sign up for insurance if they can afford it. Anyone who didn’t sign up could have state income tax returns withheld and their wages garnished to pay for care, Romney said.

“It means everyone is covered by health insurance, or they pay their own way. One or the other,” he said.

People in Safety Net would pay on a sliding scale, with the state making up the difference. If their pay goes up and makes them ineligible, they could switch to another low-cost private plan Romney proposed, called Commonwealth Care.

Romney discussed the plan on the same day that the Blue Cross Blue Shield of Massachusetts Foundation released a report on different options for universal health coverage.

The report said Massachusetts is uniquely positioned to become the nation’s first state to create universal coverage for all residents.

“Every other industrial nation in the world has figured this out,” said Andrew Dreyfus, president of the Blue Cross Blue Shield of Massachusetts Foundation. “We think it’s time to try and sort it out here. It does seem the momentum and timing is starting to work in favor of reform.”

Barbara Roop, a co-chair of the Health Care for Massachusetts Campaign, which seeks a constitutional amendment requiring the state to make affordable health care accessible to all residents, said she was warming to Romney’s plan, after initial skepticism.

“I think the governor’s policy, as it’s been fleshed out, has become more appealing,” she said. “That doesn’t mean it can’t be made better by talking to the legislature and looking at the (Blue Cross Blue Shield) report.”

The Blue Cross Blue Shield report said universal coverage could be achieved by making individual insurance mandatory, but said it would cost the state $700 million more in revenue. Alternatively, the state could require employers to insure workers, which would cost about $900 million in new revenues.

John McDonough, executive director of Health Care for All, criticized Romney’s plan, saying it was short on details and could create incentives for employers to drop employee health insurance.

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