TEXT OF INTERVIEW
Kai Ryssdal: If you live in Iowa or New Hampshire, you're probably getting bombarded by political ads. Residents of Massachusetts, though, are hearing this:
HEALTH COVERAGE AD: I've got it, we've got it . . . Got what? Health insurance! Massachusetts residents now required to have it . . .
It, as the man said, is mandatory health coverage.
Last April, Massachusetts became the first state in the country to force its residents, rich or poor, working or not, to have some kind of health insurance. And the deadline's looming.
Helen Palmer's at the Marketplace Health Desk at WGBH in Boston with an update. Hello, Helen.
Helen Palmer: Hi there, Kai.
Ryssdal: Now, it's July the 1st for this deadline, right?
Palmer: That's the deadline for the second phase. The first phase, which was for the people basically up to 300 percent of the poverty level, the federal poverty level, that kicked off in January. And indeed, a lot of people have already signed on. The Health Connector Board, who actually organized it, they're thrilled, because they say 130,000 newly-insured Massachusetts residents are out there now that weren't insured before.
Ryssdal: Now my assumption, Helen, would be that that's mostly uninsured, right?
Palmer: That's previously uninsured and low-income. There wasn't anything available for them, they didn't qualify for Medicaid, and people in many cases don't pay anything — not even premiums. And that's really been a roaring success.
Ryssdal: All right, but what about the people who do have to pay? Are they signing up at all?
Palmer: The latest figures suggest people are signing on at about a rate of a hundred a week. Which is not actually terribly good. But the head of the Connector Board, John Kingsdale, he says they're really on a push to actually get the word out now:
John Kingsdale: We've sent postcards to 3.3 million taxpayers and letters to 193,000 businesses. So we're starting to get the word out broadly to the public — but just starting.
Palmer: Now, Kingsdale says he thinks that enrollment will pick up. I mean, the premiums are quite modest, he says — they range from as little as $184 a month for, say, a 37-year-old in Boston, to about $290 a month for the soup-to-nuts kind of plan. But all the health care advocates say, well, that's not all the story — there are deductibles which people aren't used to. And there are copays, too, that they may not be used to.
Ryssdal: All right. But if I remember from the initial news reports of this program, there are penalties for people not signing up, aren't there?
Palmer: Yes. But actually, the penalties aren't terribly steep this first year. I mean, the first year, they'll lose their state tax exemption, that's about $218. But that's not actually very much, it will be more than that the year . . . the second year — they could face a fine of about $1,200. But not this year.
Ryssdal: Helen, tell me about employers up there. How are they feeling about this plan?
Palmer: Well, they're not particularly on board, according to Bill Vernon. He's the Massachusetts director of the National Federation of Independent Businesses. He says there's a kind of "wait and see" attitude, that they don't like the idea of government mandating that they have to give health insurance. They are setting up plans to enable their workers to contribute with pretax dollars. And if they don't actually set up some kind of mechanism like this, then the companies could face penalties of $295 per worker per year for not enabling them to buy health insurance this way.
Kingsdale: If you have multiple employees who are accessing the free care pool, you could liable for tens of thousands of dollars if the proverbial, you know, train wreck occurred.
Ryssdal: You know, a year, year and a half ago, when news of this plan broke, it was big news all over the country. It was the next greatest thing in health care. It sort of faded from the national spotlight, Helen. How are people feeling about it up there?
Palmer: It's strange, but there is a real air of excitement here. I mean, all we're hearing is the problems, "Is the money gonna work? Is the money gonna stretch? Are the premiums gonna go up next year?" But equally, people are terribly excited about the whole idea of being the forefront of this experiment, of being maybe the way that we get some kind of universal coverage for the whole country. And they see themselves as pioneers, and there's a great deal of excitement about being in that position here in Massachusetts.
Ryssdal: Helen Palmer at the Marketplace Health Desk at WGBH in Boston, in the Bay State. Helen, thank you.
Palmer: My pleasure, Kai.