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Massachusetts health care — wonky, with a healthy dose of reality

MA Health Reform Is Catching on: NJ, IL, CA

MA Health Reform Is Catching on: NJ, IL, CA

December 13, 2006

News from three key states again demonstrates that MA-style health reform has legs. How long, how durable -- yet to be determined. But legs it has.

New Jersey lawmakers "are drawing up a proposal that would provide medical insurance to all state residents, including the more than 1.2 million people who are now uninsured. The plan, which could be introduced as legislation as soon as March but may not be enacted for years, would compel each of the state’s roughly eight million residents to sign up for insurance plans. New Jersey residents who do not have coverage would enroll in a plan sponsored by the state. All told, officials said, the plan could cost as much as $1.7 billion in the first year, a figure that would fall once the premiums of those who already have private insurance are excluded." Click here for the full NYTimes story.

Meanwhile, in Illinois a "state task force on Thursday recommended a far-reaching reform of Illinois' health care system that would require most employers to offer medical coverage and calls for $3.6 billion in new state spending. The plan also recommends an "individual mandate," which would require every state resident to obtain health insurance or pay a penalty. People who make less than 400% of the federal poverty line would qualify for some state subsidies. For an individual, 400% of the poverty line is currently $39,200. The proposal comes from a 29-member panel created through a 2004 law that set as Illinois' official policy 'to insure that all residents have access to quality health care.' The task force, appointed by Gov. Rod Blagojevich and the four legislative leaders, will report its recommendations to the General Assembly in January." Click here for the Chicago Business report.

Finally, from California, Kaiser's George Halvorson and colleagues present a universal coverage plan for California -- "We describe several subsidized benefit options for low-income uninsured Californians, emphasizing preventive and primary care, and we propose catastrophic coverage, at a minimum, for higher-income uninsured Californians. Proposed financing mechanisms include a health care sales tax and an "in-lieu" payroll tax" -- that looks strikingly inspired by the Massachusetts plan -- though with a much heftier payroll tax on employers that don't provide health coverage to their workers. Click here for the Health Affairs web article.

Each plan contains -- individual and employer mandates along with subsidized coverage for uninsured with incomes below 300% fpl. Each plan acknowledges inspiration from the MA reform law. And each costs big new bucks.