Healthcare Bill Is a Vital Sign of Bipartisan Progress
Two miracles took place in Massachusetts last week.
First, the Legislature approved the nation's most ambitious effort to expand access to health insurance.
Second, the plan emerged from a process of creative bipartisan collaboration between Republican Gov. Mitt Romney and an overwhelmingly Democratic Legislature.
At a time when Washington is locked in partisan warfare on almost every front and has done little to reverse the declining access to health insurance nationwide, it's difficult to say which of Massachusetts' achievements is more remarkable. Both should inspire not only other states but the federal government as well.
The Massachusetts health plan "is an intriguing, innovative, different experiment that really demands attention and respect from folks around the country," said John E. McDonough, a former state legislator who now directs Health Care for All, an advocacy group. "It is an amalgam of left and right approaches that I have not seen."
The legislation, which Romney plans to sign this week, aims to provide health insurance to 95% of the roughly half a million state residents without it.
As McDonough suggests, the plan's secret is that it blends ideas favored by liberals and conservatives into a comprehensive attack on the stubborn problem of the uninsured (who now number nearly 46 million nationwide).
The plan's foundation, originally proposed by Romney, defines an important principle of joint responsibility between individuals and government to ensure coverage.
The plan would require all Massachusetts residents to buy health insurance, the way states now require all drivers to purchase car insurance. But the state would cover all the costs for families whose incomes are below the federal poverty level (about $20,000 annually for a family of four) and subsidize premiums, on a sliding scale, for those earning up to three times that amount.
The plan would establish an innovative insurance exchange that would offer individuals and small businesses a variety of policies to purchase. It would provide health insurers more leeway to offer stripped-down, less expensive policies, especially for young people. It also would expand government-provided Medicaid for children in working-poor families and would require employers that don't cover their workers to contribute to the cost of the state premium subsidies.
That thumbnail hints at the plan's brilliant political balancing.
