SIGNING UP THE NEXT 200,000 FOR INSURANCE WILL BE A BIG CHALLENGE by Richard Lord

The most recent enrollment numbers indicate that approximately 200,000 individuals in Massachusetts, who were uninsured 16 months ago, have health care coverage today. That certainly is great news and should be celebrated by all of those who have been involved in the health reform effort in the Commonwealth. However, a closer examination reveals that most of those newly covered individuals are either enrolled in the state’s Medicaid program or are receiving heavily subsidized insurance through the state’s new Commonwealth Care program. Although that is not totally unexpected – why wouldn’t anyone enroll in programs that provide free or almost free health care – the increased costs to the Commonwealth could present future fiscal concerns. Additionally, it will be very interesting to see whether higher income residents not eligible for subsidized care comply with the looming December 31st deadline when penalties begin to kick in.

The Massachusetts health care reform law mandates that individuals over the age of 18 must have health insurance. Recent profiles of the uninsured indicate that there are significant numbers who a) are relatively young and b) earn above 300% of the federal poverty level and are therefore not eligible for state subsidies. Many of these individuals do not perceive the value of having health insurance because they are young and healthy and do not want to pay premiums that are not inexpensive, even for the young adult plans which have recently become available for 19-26 years olds through the Connector.

The requirement that individuals must have health insurance is a novel one which has never been tried anywhere else in the country. It should not be expected that we can change attitudes and perceptions overnight

which is one reason that the Legislature, in its wisdom, created a fairly modest penalty in the first year for non-compliance with the law, i.e. individuals will forfeit their personal tax exemption when they file their 2007 tax returns, which amounts to a penalty of approximately $219. However the financial penalties in future years increase substantially.

There has been a concerted effort by both the Connector and Massachusetts Health Care Reform Coalition (of which AIM is a member) to educate our citizens about their responsibilities under the new law. However recent polling data reveals that the majority of individuals are still neither aware of the deadline for obtaining coverage nor the financial penalty for failure to do so. Obviously the public awareness campaign must continue and be enhanced. Even more difficult is the challenge to convince individuals who do not see value in having health insurance that it is in their best interest – both from a personal health and financial perspective – to obtain coverage.

Richard Lord, President and CEO, Associated Industries of Massachusetts