by James Parks, Apr 6, 2006

Massachusetts’ new health care mandate, which forces uninsured workers to purchase health care coverage or face higher taxes and fines, is being hailed by its proponents as the answer to the health care coverage crisis.

But that’s a sham sale. In fact, the plan goes further than anything on the books to absolve employers of their responsibilities and shift the burden of health care costs onto workers.

The Massachusetts plan as a whole is “unconscionable” and “misguided,” says AFL-CIO President John Sweeney. “This legislation leaves middle-income families dangling without a safety net, jeopardizes families who currently have employer-sponsored health care, and gives employers a free ride.”

Rather than following its progressive history, which produced such leaders as Rep. Tip O’Neill and Sen. Edward Kennedy, the state Legislature chose to follow the playbook of ultraconservative former House Speaker Newt Gingrich, who has proposed a plan very similar to the one in Massachusetts. In an unpleasant irony, the bill was passed on April 4, the anniversary of the assassination of Martin Luther King Jr., who earned his doctorate in philosophy at Boston University and who died fighting for the rights of poor familiies.

Sweeney says the Massachusetts law punishes middle-income families: 

A typical family in which the husband and wife each earn a little more than $30,000 and who have two children, would be forced to purchase health care, but would not be qualified for any help even if their employer does not offer any coverage or they can’t afford their share of the premium. With the average employer-sponsored insurance premium costing more than $4,000 a year for single workers and close to $11,000 a year for working families, Massachusetts’ new requirement will bankrupt many middle-class families. 

As the details of the law are coming out, it appears not to be as good as it was advertised. Liz Kowalczyk reports in The Boston Globe that premiums for the poor will be at least 60 percent higher than proposed and even higher for families:

When Governor Mitt Romney dramatically proposed a universal health insurance plan a year ago, a key element was providing low-cost, pared-down coverage for about $200 a month.

But in the end, legislators were unwilling to adopt some of the measures that the governor and insurers had counted on to lower premiums, and lawmakers and an insurance executive said in interviews yesterday that they expect average premiums under the bill passed this week will be about $325 a month for individuals and as much as twice that for families.

Under the legislation, individuals who don’t qualify for the state Medicaid program or for insurance through their jobs would be forced to buy low-cost private plans. The state will pay the entire premium for individuals and families who earn less than 100 percent of the poverty level—$9,800 for a single person and $20,000 for a family of four—and will subsidize premiums for those who earn between 100 and 300 percent of the federal poverty level. Uninsured residents with incomes greater than 300 percent of the poverty level will be on their own to pay the full cost.

Now, Romney, who has his eye on the Republican presidential nomination in 2008, is poised to court corporate interests by actually reducing or eliminating the paltry annual $295 per-employee fee for certain companies who do not offer health insurance to their employees. Legislators predict the new fee will bring in roughly $48 million a year and say it’s essential that businesses with more than 10 employees make contributions to help fund the state program. The fee already was too low and “actually creates an economic incentive for many businesses to pay the assessment rather than provide health care for their workers,” Sweeney says.

The AFL-CIO union movement supports health care reforms that require employers to live up to their responsibilities and provide health care to their employees. Massachusetts’ own Sen. Kennedy has proposed legislation to require employers of more than 50 workers to provide employees with health insurance; and in January of this year, Maryland passed legislation requiring large employers, such as Wal-Mart, to insure their workers. 

“States are passing groundbreaking and precedent-setting laws. But we hope this is one precedent no other state will follow,” Sweeney says.

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