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Health care in Massachusetts

The craziest thing about interpreting Scott Brown's election as a strike against health-care reform is that Brown comes from a state that has already implemented this health-care reform and likes it. In fact, Brown voted for it and defended it on the campaign trail. Alec MacGillis explains:

While many are describing the election to fill the late Edward M. Kennedy's Senate seat as a referendum on national health-care reform, the Republican candidate rode to victory on a message more nuanced than flat-out resistance to universal health coverage: Massachusetts residents, he said, already had insurance and should not have to pay for it elsewhere.

Scott Brown, the Republican state senator who won a stunning upset in Tuesday's election, voted for the state's health-care legislation, which was signed by then-Gov. Mitt Romney (R) and has covered all but 3 percent of Massachusetts residents. That legislation became the basic model for national health-care legislation. Brown has not disavowed his support for the state's law, which retains majority backing in Massachusetts.

Instead, he argued on the campaign trail that Massachusetts had taken care of its own uninsured, and it would not be in the state's interest to contribute to an effort to cover the uninsured nationwide.

"We have insurance here in Massachusetts," he said in a campaign debate. "I'm not going to be subsidizing for the next three, five years, pick a number, subsidizing what other states have failed to do."

In a news conference Wednesday, he said, "There are some very good things in the national plan that's being proposed, but if you look at -- and really almost in a parochial manner -- we need to look out for Massachusetts first. . . . The thing I'm hearing all throughout the state is, 'What about us?' "

Incidentally, the federal government subsidizes a substantial share of Massachusetts's reform plan through its Medicaid waivers, which makes this "we got ours" attitude all the more noxious.

By Ezra Klein  |  January 21, 2010; 4:11 PM ET
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>>the federal government subsidizes a substantial share of Massachusetts's reform plan through its Medicaid waivers>>

An administration with balls might regard this as a pressure point.

Posted by: fuse | January 21, 2010 4:33 PM | Report abuse

HCR is DEFICIT REDUCTION legislation. That is, it saves taxpayers, including Massachusetts taxpayers, more than is costs--way more.

Why can't politicos, pundits, and voters get that through their thick skulls?

Posted by: cjo30080 | January 21, 2010 4:44 PM | Report abuse

From what I'm hearing, the GOP is positioning the MA bill as the ideal and that if the Dems would only make the national plan more like MA and accept all the brilliant input from the GOP that's just waiting to burst forth, then we'd be getting somewhere. They of course make no sense but since nobody in a position to point that out points that out, they get away with it.

Posted by: eRobin1 | January 21, 2010 4:45 PM | Report abuse

The only catch is that it appears to be driving the cost of health care up in MA. If prices are rising faster there, we need to figure out a different kind of plan...

Posted by: staticvars | January 21, 2010 5:02 PM | Report abuse

So is Brown a gettable vote for HCR then?

It may sound crazy, but if keeping Massachusetts from paying for national reform is all he wants, that shouldn't be so hard accomplish. If I understand it correctly, MA can opt of HCR since they already cover more people than the federal bill would. So just add an amendment stating that if a state opts out, whatever amount that would have been paid to its population in subsidies had it remained in the system, will instead be paid directly to the state. Seems fair to me. After all, MA residents will not be able to opt out of the pay-fors for HCR, like the increased medicare tax on high income earners.

Brown has promised he will be independent from his party, and if he has ambitions of ever being more than a half-term senator, that really is his only option. So who knows, this may be the reason Obama urged the Senate not to cram anything through until Brown is seated.

Posted by: hansr | January 21, 2010 5:48 PM | Report abuse

Off-the-wall suggestion:

What if the Administration/Dems in Congress were to push legislation that, essentially, would pick up the bill for any state that enacted a "Massachusetts-type" plan? The funding could come from a "Cadillac plan tax".

Posted by: Craig643 | January 21, 2010 6:05 PM | Report abuse

Really ugly selfish attitude.

We have universal health insurance so we don't give a crap about the rest of the country.

This is what Republican politicians call patriotism?

Oh yeah, their patriotism means no sacrifice or effort. You just wear a flag pin.

Posted by: RichardHSerlin | January 21, 2010 7:56 PM | Report abuse

massachusetts residents pay the highest insurance premiums in the country (those who pay full freight that is). whatever the polls say many people are very unhappy with the system and many pay outrageous premiums for not so great high deductible plans. again, the only people who get a break are those who are really down and out or in some preferred group. rest get to pick up the tab.


Posted by: davidring | January 21, 2010 9:17 PM | Report abuse

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