Thoughts on Massachusetts’ new health care law

[xiphias]

So, Massachusetts is implementing new rules that are designed to require everyone in the Commonwealth to have health insurance.

It is the most bizarre and byzantine set of health care regulations anyone could imagine. It involves penalizing people on their taxes if they don’t have health care, penalizing businesses that don’t offer health care to their workers because they’re not legally required to do so, having subsidized health care plans, and a bunch of other things.

A lot of people on my friends list are annoyed-to-upset with it on libertarianish principles, in that it’s forcing people to buy a product because it’s good for them, which is very nanny-state-ish. And I see their point. In my mind, I’m less bothered by it, because it’s fundamentally like charging a tax to everyone and then earmarking that money to have the Commonwealth buy health insurance for folks (which, admittedly, wouldn’t be any better from a Libertarian point of view, and, from a practical point of view, would be worse, as the Commonwealth would end up using the money for something else, anyway).

But, there’s one question I’ve not really heard anyone talking about.

Will it work?

And my answer is, “I haven’t a frickin’ clue.”

It is rare for me to have absolutely no gut feeling on what the effects of a piece of legislation will be. I’m not always right, of course, but I usually have SOME sort of feeling one way or another about whether it will have more-or-less the effects it’s designed to have.

I’ve got absolutely no feeling about this one.

It could be horrifically disastrous. It could be brilliant. I really don’t know.

It’d be fantastic if it actually goes forth and ends up with everyone in Massachusetts having reasonably affordable health care. And, well, I’ve got no reason to suspect that it WON’T work.

I’ve also got no reason to suspect that it WILL work.

This is truly a strange situation to be in.

Comments

[bradhicks.livejournal.com]

What exactly does it do to penalize people who are out of work and/or disabled and don't have health insurance? I'm confused.

[adrian-turtle.livejournal.com]

People who are disabled get medicaid and social security disability. The penalties are supposed to be for people who are employed, and making more than some threshold income, with the option to purchase health insurance, who choose not to insure themselves. (There's also penalties for companies that don't subsidize insurance for their employees. It's complicated.) All the penalties go into a fund that the state will use to provide health insurance for poor people -- people who have too much money to be eligible for medicaid, but not enough for the threshold income that would require them to buy their own.

I'm concerned about the complexity of the system. I don't understand all of it, having only read a few newspaper articles about it, but it seems like there's an awful lot of opportunity for fraud and administrative stalling. Even if everyone is perfectly honest and trying really hard to be helpful, increasing complexity tends to increase administrative costs and increase the risk of expensive mistakes.

[burgundy.livejournal.com]

I've only heard a few pieces on NPR, but this is what I've gathered thus far: There will be low-cost alternatives offered, though I don't know if these will be under direct state control or if they've just made arrangements with private providers or what. People who make less than 300% poverty level income get special deals, though I no longer remember exactly what those deals will be (free, or extra discount, or what). The people I most worry about are the ones making just above 300% who don't get insurance through work, because frankly that's not a huge amount of money given how much individual policies can cost. I don't know how expensive the plans they'll be eligible for will be.

[xiphias.livejournal.com]

You pay an extra $500 on your taxes if you don't have health care. If you're disabled, or unemployed, you can get subsidized health care. So you end up in a situation where you can either pay $500 for health care, or $500 for not health care.

And if you can't even pay $500, you can theoretically pay even less and get health care. That's the idea, anyway.

Is it going to work? See the above and oft-repeated, "I have no frickin' clue."