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Romney's Mission: Massachusetts Health Care

Gov. Mitt Romney introduces President Bush at a Republican Governors Association dinner in February 2006. Romney now has before him a bill that would require all Massachusetts citizens to have health insurance.
Dennis Brack-Pool/Getty Images
Gov. Mitt Romney introduces President Bush at a Republican Governors Association dinner in February 2006. Romney now has before him a bill that would require all Massachusetts citizens to have health insurance.

This week, Massachusetts enacted legislation to provide health insurance for virtually every citizen within the next three years. Gov. Mitt Romney says he'll sign it into law. The measure would be the first in the nation to require people to buy health insurance if they don't get it at work.

Under the plan, all but the smallest companies will face financial penalties if they don't cover their workers. The bipartisan plan is already being talked about as a national model.

House Speaker Sal DiMasi compares the new health law to the Mayflower Compact that the pilgrims wrote after they landed on Plymouth Rock in 1620.

"It was supposed to be a community of people where laws were made for the common wealth. That's why we became a commonwealth," he said.

DiMasi, a Democrat, says the new law reflects that original idea.

"Nobody in Massachusetts will ever be turned away for health care," he says.

Gov. Romney, a Republican and a former businessman, bases his support on economics. When Romney became governor three years ago, a business colleague urged him to do something about the 500,000 or more Massachusetts residents without health insurance. Nearly nine out of ten are in working families.

After studying the problem, Romney says, he came away with a key insight: "People who don't have insurance nonetheless receive health care. And it's expensive."

Medical care for Massachusetts patients who lack health insurance is paid for by businesses. Companies -- mostly ones that already offer coverage to their employees -- subsidize a fund that pays for so-called "free" care when uninsured people end up in hospitals.

"We're spending a billion dollars giving health care to people who don't have insurance," Romney says. "And my question was: Could we take that billion dollars and help the poor purchase insurance? Let them pay what they can afford. We'll subsidize what they can't."

The governor's plan was endorsed by Democrats. And before long, it had attracted a coalition of business leaders and consumer advocates, insurance executives and clergymen, hospital CEO's and poor people.

After three years of work, only two legislators voted against the plan -- a carefully crafted, $1.3 billion bill that promises near-universal coverage.

The law says people earning under three times the federal poverty level --- that's $29,000 a year for an individual --- can buy a state-subsidized health plan with no deductibles and rich benefits, including dental care.

In promoting the plan, Romney brushes off those in his party who attacked the plan as just another big-government scheme. He emphasized that those who can afford insurance should get it.

"Otherwise you're just passing your expenses on to someone else," Romney said. "That's not Republican, that's not Democratic, that's not Libertarian. That's just wrong."

Ed Haislmaier, of the The Heritage Foundation, a conservative Washington think tank, which helped frame the legislation -- agrees with Romney.

For proof of the plan's worth, Haislmaier says, critics should look at who passed it: a Republican governor and a Democrat-dominated House.

"I don't care what the name of the state is," Haislmaier says. "It just tells anybody in the street there must be something there if you can get that to happen."

After all, Haislmaier says, welfare reform didn't happen on the federal level until Wisconsin did it first.

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Since he joined NPR in 2000, Knox has covered a broad range of issues and events in public health, medicine, and science. His reports can be heard on NPR's Morning Edition, All Things Considered, Weekend Edition, Talk of the Nation, and newscasts.
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