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Massachusetts’ ‘Reform’ Mess

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FEDERAL lawmakers pondering how to vote on Obama-Care this week should notice that Massachusetts is back asking Washington for hundreds of millions more to bail out its universal health-coverage system.

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When it became law in 2006, the Bay State's plan was supposed to fix everything - with much the same exact "medicine" as in the current national "reform" bills.

Everyone would have to buy insurance on threat of a $1,116 fine. Meanwhile, bureaucrats would redirect large amounts of federal and state money already sloshing around the state from supporting care for the uninsured to providing subsidized insurance for these same folks. Instead of using money to patch up problems caused by a lack of insurance, the state would use the cash to provide preventive care, saving even more money down the road.

flatlineSo what happened? The state enrolled 55,000 more people in Medicaid, and folks flooded to the new free insurance and enrolled in their subsidized employer plans - but few bought private insurance.

So the total uninsured rate dropped from 10 percent of the state's 6.3 million population to just 3 percent - but the savings haven't materialized.

Of the 176,766 people enrolled in plans under the "Connector" authority set up by the state for individuals and small businesses to buy insurance, 87,838 are paying no premium and another 64,733 are subsidized. A mere 24,195, or 14 percent, are paying full fare.

This new insurance was supposed to be funded not by new federal money, but by redirecting the enormous amounts of money in the state's uncompensated care pool. Yet the need to subsidize providers of care to uninsured hasn't gone away - indeed, Massachusetts bureaucrats are seeking more money for the renamed Safety Net Care Pool. They want to keep hard dollar, openended subsidies flowing directly to hospitals and other institutions.

That's why the state is now begging the feds for $473 million - to fund the safetynet programs that were supposed to be solved by their near-universal insurance.

And this comes on top of vast aid from Washington: The 2006 reform was itself an effort to save $385 million in federal funding.

Last year, Congress granted Massachusetts another $1 billion over three years to fund its system. In all, the feds are kicking in $21.2 billion over three years - more than $3,000 per person in the state.

Yet they're already back asking for more, barely a year after the ink is dry on the deal that provided the last windfall.

The next step in Massachusetts is to impose global budgets for doctors - that is, to pay a flat fee rather than fees for service. In other words, to turn the entire state into a government-dominated HMO. (And the Bay State wants the feds to fork over another $135 million to help pay for the shift.)

In short, they don't have a clue. The only thing they know is that they want more federal cash to keep the "reformed" system afloat.

Americans must understand that the Massachusetts mess is what ObamaCare will bring. In his latest request for more money, Gov. Deval Patrick's administration actually asks for the added funds based on being a national model: "The legislation passed by each house of Congress bears a striking resemblance to the Massachusetts model."

Be afraid. The only thing Massachusetts has demonstrated is its ability to get billions out of the federal government. But where will the country as a whole go for the extra money? Only two choices: Raise taxes on ourselves today or borrow our children and grandchildren into beggarhood.

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Sally C. Pipes is president and CEO of the Pacific Research Institute and author of The Top Ten Myths of American Health Care

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