On Tuesday, President Obama signed into law U.S. health care reform legislation, leaving many Americans wondering how it will affect them, their families, and businesses.
The national health care reform bill was modelled on groundbreaking 2006 legislation in Massachusetts requiring all adults in the Commonwealth to have health insurance coverage through an individual mandate. A new article from The Milbank Quarterly, by Brandeis health policy experts, explains how Massachusetts has handled the insurance requirement since 2006 and describes the lessons policymakers have learned.
As lead author Michael Doonan, assistant professor at the Heller School at Brandeis University says, "The individual mandate is the linchpin to making health care reform work. The individual mandate forces you to define affordability, coverage limitations, and other key aspects of any successful health care reform." Doonan adds, "moving towards universal coverage makes it possible to prevent insurance companies from discriminating against people with pre-existing conditions."
Massachusetts has a head start on addressing some of the issues that will now be faced on the national level, and on a state-by-state basis. Most people still receive insurance through their employer with no changes. The previously uninsured are covered through the expansion of existing subsidized health care programs such as MassHealth (the state's Medicaid program), the Children's Health Insurance Program, and the employer-based Insurance Partnership Program. New programs, such as Commonwealth Care, were also created. Reforms also led more people to sign up for coverage at work or to purchase coverage through the new exchange, the Commonwealth Health Insurance Connector Authority.