This should raise red flags for those who believe that anything other than a Canadian or British-style system will serve the goal of covering everyone.

As the Democratic presidential candidates debate whether Americans should be forced to obtain health insurance, the people of Massachusetts are living the dilemma in real time.

A year after Massachusetts became the only state to require that individuals have health coverage, residents face deadlines to sign up or lose their personal tax exemption, worth $219 on next yearÂ’s state income tax returns. More than 200,000 previously uninsured residents have enrolled, but state officials estimate that at least that number, and perhaps twice as many, have not.

Those managing the enrollment effort say it has exceeded expectations. In particular, state-subsidized insurance packages offered to low-income residents have been so popular that the programÂ’s spending may exceed its budget by nearly $150 million.

But the reluctance of so many to enroll, along with the possible exemption of 60,000 residents who cannot afford premiums, has raised questions about whether even a mandate can guarantee truly universal coverage.

Additional concerns have been generated by projections that the stateÂ’s insurers plan to raise rates 10 percent to 12 percent next year, twice this yearÂ’s national average. That would undercut the planÂ’s secondary goal of slowing the increase in health costs.

Personally, I'm interested in seeing how this impacts the Romney campaign. After all, mitt signed this measure into law before he left office, and it has been mentioned by some as a signature accomplishment. However, he has not proposed a federal program along these lines, and has come out against a national insurance plan, preferring to leave the matter to the states.

In the end, though, this provides ammunition for both sides of the health care debate -- those favoring it able to show that only a single-payer system can get universal coverage, and those opposed able to point to the price increases as a natural consequence of government interference with the health care market.

Posted by: Greg at 04:02 AM | No Comments | Add Comment
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