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KAI RYSSDAL: Tomorrow, the first key deadline in one of this country's biggest health-care experiments... Everyone who lives in Massachusetts will have to have signed up for insurance. The policies have to be in effect by December 31st. Missing either deadline will trigger penalties.
The plan has spread beyond just Massachusetts -- not necessarily to other states, but to the presidential campaign. Marketplace's Steve Tripoli has an early report card on the Bay State's try at universal coverage.
Steve Tripoli: There are 400- to 600,000 uninsured in Massachusetts. The state's new Commonwealth Connector agency offers plans with group rates for all and subsidies for some. But only half, at most, of those without insurance have signed up so far. Connector spokesman Dick Powers says the imperfect enrollment numbers aren't unexpected:
Dick Powers: This is a marathon, it's not a sprint. It took three years to pass health-care reform in Massachusetts, and it will also take time to implement the program.
Powers says it could be three more years before everyone's covered. And getting there might mean tweaking the new law.
Powers: Nobody else in the country has tried this before -- so I would just say, simply stay tuned for changes.
The state's business community remains generally supportive. The University of Chicago's Jon Gabel just finished surveying Massachusetts businesses about the law. He says their overall level of support has been one surprise.
Jon Gabel: And number two, to date, we show no evidence of crowd-out. And by crowd-out, I mean employers dropping coverage so they could get picked up on government-subsidized plans.
Gabel says the rest of America shouldn't think that healthier, wealthier, more-educated Massachusetts is an exception. In fact, he says it's tougher here in some ways. For one thing, health insurance policies costs substantially more in Massachusetts.
Gabel: And secondly, and more important, is that employees must contribute about 80 percent more for single coverage in Massachusetts than they do in the rest of the nation.
Gabel believes what's holding things together here so far is the fact that business, unions and everyone else took part in designing the law. It probably also helps that most players see the alternatives as less attractive.
In Boston, I'm Steve Tripoli for Marketplace.