Saturday, April 14, 2012

Over at Forbes is a fascinating analysis of the Massachusetts health care reform law, Romney's proposals vs the state legislature:
Romney’s big idea was to free insurers from the state’s costly 1996 insurance mandates, allowing individuals to buy inexpensive insurance that would meet their most urgent needs. But the health law he signed in 2006 did not specify the types of plans that insurers were required to offer. “The specific definition of [minimum creditable coverage under the mandate] was left to the board of the Health Connector to decide,” recounts Josh Archambault.

Romney’s goal, with the individual mandate, was to require people to buy catastrophic insurance that would cover emergency care. Romney’s version of the mandate was designed to compensate for the effects of the federal EMTALA law, that requires hospitals to provide emergency care to everyone, regardless of their ability to pay. “Therefore,” writes Archambault, “the original 2005 legislation filed by Governor Romney required that Massachusetts residents carry, at a minimum, catastrophic medical coverage, or in lieu of such coverage, a $10,000 bond…an approach that tracked the Commonwealth’s requirement for automobile insurance coverage.”

However, the bill that emerged out of the Democratic legislature contained a different mandate. The Democratic version did not restrict the mandate to catastrophic insurance, and it replaced the bond provision with a direct fine. Furthermore, according to Archambault, when Deval Patrick assumed office, he populated the Health Connector board with progressives who favored mandating costly comprehensive insurance, instead of cheaper catastrophic coverage.

Romney was up against a heavily partisan legislature,
In the end, it didn’t matter what Romney thought about the employer mandate. The Democrats controlled 85 percent of the legislature. After the bill-signing ceremony was over, they went back to the State House and overrode each of Romney’s eight vetoes.

Read the whole thing.
 
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