The Road to Universal Coverage
April 6, 2006
On Tuesday, Massachusetts became the first state to mandate health insurance for all its residents, overwhelmingly passing a bill in the state House and Senate. The bill is a promising step on the path toward universal coverage, and Massachusetts should be commended for "thinking big" about health care coverage. Other states are also taking on the problem of health care — at least eight other states have bills calling for universal coverage. But while we applaud Massachusetts for their efforts, the reality is that this plan will not work in other states. Hopefully the focus on Massachusetts will highlight the need for comprehensive universal coverage on a national scale. It should be unacceptable to all that 16 percent of Americans are currently without health insurance.
- The Massachusetts bill is a good step towards universal coverage, but it overburdens the middle class. There are some good things about the Massachusetts bill: State and federal governments will fully cover the nearly 100,000 people who qualify for Medicaid but have not yet signed up and it will also heavily subsidize another 200,000 uninsured residents who are low income. However, a third group of approximately 200,000 "higher-income" individuals will be expected to purchase their own health insurance or face stiff tax penalties of up to $1000 per individual, which do not speak to issues of affordability. But employers who fail to offer health insurance will face penalties of only up to $295 per employee. As the Progressive Legislative Action Network (PLAN) notes, this bill protects the lowest-income members of society but places "an unfair burden on struggling working and middle class families."
- A state-by-state approach to health care is not what is best for this country. Many conservatives support a state-by-state approach to health care. But the Massachusetts plan cannot be used as a model for the rest of the country. The Century Foundation’s Leif Wellington Haase notes that, “Massachusetts has several features that are very advantageous to reaching universal coverage. These will be hard to replicate in many states. The state has very high rates of public and private coverage and one of the lowest percentages of uninsured residents in the country. … Almost two-thirds of employers offer health insurance to their employers, compared with 56 percent nationally." Real reform needs to take place at the federal level.
- This underscores the need for comprehensive national reform of our health care system. The American health care system is broken. It is riddled with "inefficiencies, excessive administrative expenses, inflated prices, poor management, inappropriate care, waste and fraud." And yet, the federal government has not taken serious measures to enact reform. President Bush spent yesterday talking about health care — not once mentioning Massachusetts — but focusing on his “health savings accounts.” Sen. Charles Grassley (R-IA) has dismissed Bush's cosmetic attempts at reform: "We want to believe that if we just spend more money or provide more tax subsidies, our problems will magically disappear." Fair, responsible, universal coverage is possible on a national level and American Progress has a plan to guarantee every American affordable, quality health care.
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