Universal Health Care Initiative – Massachusetts

A bill to create the Advisory Committee on Consolidated Health Care Financing was passed and funded in the summer of 2000. It was part of compromise legislation drawn up as a result of the statewide ballot initiative for a universal program. (For more about the ballot initiative, see Medical Student JAMA, October 1, 2003.) The committee’s mandate was to analyze a financing system for health care "accessible to every resident of the commonwealth". A final report was published in December 2002.

A universal single payer bill has been introduced in each session since 2002. Like Connecticut’s bill, the Massachusetts Health Care Trust Bill would create a state trust fund to collect all health care monies and pay all providers for all residents of Massachusetts.

InJuly 2004 the legislature approved a citizens’ initiative that would add a right to “comprehensive, affordable and equitably financed health insurance coverage” to the state constitution. The initiative, sponsored by the Health Care for Massachusetts Campaign, must be approved again in the 2005 session if it is to reach the ballot in 2006.

Health Care for All Massachusetts is sponsoring the Health Access and Affordability Act, which combines expanded access to MassHealth with a requirement that employers cover their workers or pay an assessment. The act guarantees coverage for Massachusetts citizens earning less than 200 percent of poverty, and offers coverage on sliding scale rates for people with incomes under 400 percent of poverty. Employers are required to facilitate enrolment of all uninsured workers in a health plan, and those that do not cover their workers will be assessed a percentage of their total payroll to finance MassHealth. The act also includes cost containment measures, including reinsurance of catastrophic health care costs.

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