10 Signs That Mass. Mostly Likes Health Reform, Really And Truly

You know how it is: When your town or your company or, heaven forbid, your family or friends are portrayed in the media, its funhouse mirror tends to distort them almost beyond recognition. That's a bit how it felt during the Supreme Court health law hearings this week as national media outlets turned their spotlight onto Massachusetts and came up with headlines like this one in The New York Times: "In Massachusetts, Insurance Mandate Stirs Some Dissent."

I mean, not that there's no dissent here. Of course there is. A WBUR poll earlier this year found that 33% of residents oppose the state's health reform law. But I think many of us would agree that the newsworthy, surprising, man-bites-dog moment here is how little dissent there's been. (Kudos to the Worcester Telegram & Gazette for choosing this headline for that same Times story: "A few Mass. residents still without health insurance.")

We asked WBUR's Martha Bebinger, who has covered Massachusetts health reform with unmatched energy and expertise since before it passed in 2006, for a reality check. "I've been looking for a movement of dissenters for six years and haven't found it," she said. "I have a handful of people I call regularly and ask, 'Are you doing anything?'"

[module align="left" width="half" type="pull-quote"]The Facebook page for 'Massachusetts Against The Individual Mandate' got only43 'Likes.'[/module]

Here are 10 points that back up our impression that health reform has turned out to be strikingly palatable to most here in Massachusetts:

• A WBUR poll released in February of this year found that  62 percent of residents support the Massachusetts health reform law while 33 percent oppose it. (In the WBUR report on the poll, pollster Robert Blendon notes that people outside the state have a hard time believing how accepted the reform is here.)

• A 2011 poll by The Boston Globe and the Harvard School of Public Health similarly showed that 63 percent of Massachusetts residents supported the state law, and that support had risen since 2009. The federal law has an approval rate of 41 percent, and an unfavorable view by 41 percent of those surveyed, according to a monthly tracking poll by Kaiser.

• In Massachusetts, there have been no major court challenges or attempts to overturn the health insurance requirement.

• Backers of an initiative to repeal the individual mandate in Mass. failed this fall to get enough signatures to appear on the ballot.

• Not only did they fail to gather enough signatures, but the Facebook page for "Massachusetts Against The Individual Mandate" got only 43 'Likes.'

• At latest count, 98.1% of Massachusetts residents actually had health insurance, by far the highest rate in the country.
 • 99% of tax filers comply with the requirement to show that they have health insurance. (The penalty kicks in if you can't prove you have adequate health insurance.)

• The number of people paying the penalty has been going down ever year, Martha reports. She notes that the state does not penalize residents for whom health insurance is not affordable (although the state, not the individual decides what is affordable).  In 2009, the state automatically waived the penalty for more than 40,000 residents because they could not afford coverage.

•The number of appeals of the penalties is strikingly few: Only a couple of thousand a year in a state of over 6 million people.

Note: Though few actually pay it, he threat of the penalty can be plenty unpleasant. Martha's reporting on the WBUR poll included this:

Cummington resident Paula Zindler, another undecided voter, said the state law, which both Brown and Warren support, has forced up the cost of her health coverage.

“We had to switch to a different carrier, ’cause my insurance, I was told, was inadequate,” Zindler explained. “So I either had to change my insurance or pay a fine, and I’m not happy with that.”

•Of the Massachusetts people who've appealed the penalty, the majority generally win and are allowed to go without paying, according to the Connector.

All in all, there just doesn't seem to be a very large pool of people who feel directly damaged enough to be up in arms. It should be noted: Massachusetts had an unusually high rate of health insurance even before the health law was passed, and many of the residents who had lacked insurance qualified for free or subsidized policies.

I wouldn't call this a data point, but even the self-same New York Times that wrote about Massachusetts dissent this week proclaimed Massachusetts health reform a resounding and well-accepted success last May.

I messaged Brian Rosman of the nonprofit Health Care For All, which backs health reform in Massachusetts, with a perplexed query, saying the "some dissent" coverage struck me as a "glass half full" description when in fact there were only a few drops in the glass. Would Health Care For All respond? Part of his reply:

For virtually every single Bay Stater – some 98% - health reform has led to secure, affordable coverage. The mandate works when combined with employer fair share requirements, a Connector that makes it easy to shop for coverage, and sliding scale help for low income people...The Massachusetts health reform glass is very, very full – right up to the brim.