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Globe Editorial

The health law is working

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February 10, 2008

DON'T BE fooled by the national press coverage suggesting the Massachusetts health plan is in trouble. The plan is suffering from a bit too much success, but the state has the resources to pay for it this year and next.

Enrollment in Commonwealth Care, the subsidized insurance offering, is higher than anticipated, but Governor Patrick and the Legislature are ready to pay the extra costs this year. In the fiscal year that begins this July, the governor has budgeted $869 million for Commonwealth Care, but over half that increase will be defrayed by the federal government. Rising costs are inevitable as the plan is rolled out.

Barring a financial collapse, the state will have the money to pay for the health initiative through fiscal 2009. In case more is needed, House Speaker Salvatore DiMasi and Senate President Therese Murray are talking about a cigarette tax increase. The Legislature will not let this initiative fail for want of money.

The state needs continued federal support for the plan. To seek this aid, it has to make three-year cost estimates. Much is uncertain about healthcare economics over the next few years, so it is wise not to panic about imprecise forecasts - in this case a $1.35 billion cost in 2011. Instead, providers, insurers, consumers, businesses, labor, and the government need to unite around a campaign to control costs.

Even though Massachusetts is a high-cost state, buffeted by competitors on all sides, and dependent on federal policies it cannot control, its elected representatives resolved to do what no state has ever attempted: require everyone (with hardship exemptions) to get health insurance and provide the means for most of them to afford it.

In a little less than two years, here's what Massachusetts has achieved:

  • Expanded Medicaid by 60,000 for the poor and near poor and children.

  • Established Commonwealth Care to provide insurance for adults living near poverty - more than 169,000 enrolled.
  • Created Commonwealth Choice policies for more affluent people - 16,000 enrolled.
  • Merged the individual and small-group markets so the self-employed can buy affordable insurance and encouraged businesses to set up programs so employees could get a tax savings on premiums - tens of thousands more enrolled in private insurance.
  • Structured an individual mandate so penalties only fall on those for whom affordable coverage is available.
  • Provided a national model to show how different interest groups can unite to support significant social progress.
  • Governor Arnold Schwarzenegger's plan to do something similar died in a California Senate committee recently. In Massachusetts, the coalition behind the health reform law is holding firm. The plan itself is creative and sound. Who dares call this a failure?

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