Mass. Officials Cite Early Success for Mandatory Health Benefit Law

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As Massachusetts’ landmark health care law nears another crucial deadline, its ripple effects continue to spread across the state and country.

This week those charged with overseeing the law toasted what they said has been its single most dramatic success: the addition of about 300,000 Massachusetts residents to the ranks of the insured.

They also said the law’s success in Massachusetts — with its goal on near-universal coverage — should offer inspiration to other states.

“Massachusetts is proving that health care reform can work on a state level,” Lt. Gov. Timothy Murray said.

Murray said the initial success is even more remarkable given the fact the state had ventured into largely uncharted territory when it drafted a plan that required the cooperation of state government, private business, health insurers and the public.

“There has been no model for Massachusetts to follow,” he said.

The law may face its toughest test after Jan. 1. That’s the deadline by which virtually everyone in Massachusetts will be required to have health insurance or face the loss of their personal exemption when they file their state taxes in April — a loss of $219.

Those penalties will increase dramatically in future years.

How many people may be subject to those penalties is anyone’s guess. Even as they touted the 300,000 newly insured in Massachusetts, officials were unable to give a good estimate of how many people remain without health care.

Leslie Kirwan, Gov. Deval Patrick’s top budget chief and chairwoman of the board overseeing the health care law, said estimates of the number of uninsured in Massachusetts before the law took effect ranged from 370,000 to well more than half a million.

Rather than coming up with an entirely new health care infrastructure for the state, Massachusetts’ plan seeks to plug holes in the existing system.

The poorest receive free care. Those making between one and three times the federal poverty level can apply for subsidized plans, which require they pay an increasing percentage of premiums based on their income.

Those not eligible for subsidized plans are required to obtain insurance privately, although under the law, insurers were encouraged to come up with lower cost plans.

It’s a complex model, and it isn’t cheap. Although much of the money comes from an existing pool of state money used to reimburse hospitals for providing free care, the very success of the plan could drive up costs.

Even with its complexity and costs, the Massachusetts experiment has caught the attention of states from Rhode Island to California and entered the public debate in the race for president.

In Rhode Island, top officials have been meeting every other week to study the Massachusetts law and see what parts could work there.

And in California, Gov. Arnold Schwarzenegger is urging people to start thinking about health insurance the way they do auto insurance — as a responsibility everyone must shoulder. The so-called “individual mandate” is a key element of the Massachusetts law.

All the attention hasn’t escaped notice in Massachusetts.

“In this national debate for the presidency of the United States, what do they talk about? Modeling their plan after the Massachusetts health care reform law,” said House Speaker Salvatore DiMasi, D-Boston.

The law has become part of the lexicon of the presidential debate in large part because of the candidacy of former Massachusetts Gov. Mitt Romney.

Romney helped push for the law, although he vetoed a section that would penalize larger companies that don’t provide access to health care plans. Lawmakers overrode the veto.

On the campaign trail, most of the candidates from both parties have floated their own health care plans, many of which echo key parts of the Massachusetts law, including the individual mandate. At the same time Romney has distanced himself from the mandate, saying as president he would leave it up to the states to devise their own plans.

Max and Amy Newell say that without the law, they’re not sure they could afford health care for themselves and their two young children. The two were paying $1,200 a month and said they were able to find an acceptable plan for $640 under the law.

Max Newell said the plan allows the two to work independently and spend more time with their children.

“We feel we could not have this configuration … without this law,” Newell said.