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Posted at 3:30 PM ET, 12/20/2010

A world with an individual mandate, cont'd

By Ezra Klein

A Massachusetts reader writes in:

I'm a resident of MA, although I get insurance through my employer, where this year we were able to choose between a whopping two different insurance plans. Out of curiosity, I went to the website of the MA health connector, and I would recommend it as an enlightening exercise to you and any other interested readers.

If you click through a few options describing your situation, you'll get to a page that displays your choices for a health plan (if you lived in MA). It is nothing short of astounding. All the different plans are clearly arranged in a table according to the benefit level they offer, with out-of-pocket costs clearly indicated. For any given level of benefits, you can see all the companies offering that type of plan and the monthly premium. Not-so-surprisingly, it becomes perfectly clear that some companies offer a given plan at 50% higher cost than others. It's no small wonder then that competition is driving down premiums in the exchange. Now this is what a health care marketplace looks like!

By Ezra Klein  | December 20, 2010; 3:30 PM ET
Categories:  Health Reform  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati   Google Buzz   Previous: Earmarks and executive power
Next: More problems with funding government through a Continuing Resolution


I wonder if there is a column in the table marked "Subject to death panel approval (Yes/No/Maybe)".

Posted by: willows1 | December 20, 2010 3:42 PM | Report abuse

I went to that website and compared the cost of the plan I have here in West Virgina to the cost of a similar pan in Boston. The Boston plan was nearly twice as much! You guys in Massachusetts are so altruistic that you are willing to pay twice as much as we do here in West Virgina so that you can brag that everyone has health insurance.

Posted by: cummije5 | December 20, 2010 3:56 PM | Report abuse

Awesome website. If every American had access to such choices, no Congress could never take them away.

I'm worried about court challenges to ACA, not to mention DADT repeal, Congressional redistricting, among many other things, given that so many Obama nominations have been ignored and will expire if not acted on by the end of this session.

Why does Reid think that getting votes on just 19 nominees is sufficient?

Posted by: paul65 | December 20, 2010 4:00 PM | Report abuse

Massachusetts had horribly expensive health care before the insurance reforms. Arguably they have better health care (Consumer Reports gives a high rating to some Boston health maintenance organization). Arguably, Mass. also has hospitals that use their prestige to sustain high prices.

Posted by: DaveoftheCoonties | December 20, 2010 4:03 PM | Report abuse

If there was a "love" upgrade from "like" button I would hit it now.


Posted by: chrisgaun | December 20, 2010 4:04 PM | Report abuse

Hey cummije5: Yeah, right.

Why don't you post links to your health plan so that all of us can compare? Oh, you can't? I wonder why.... :)

Posted by: paul65 | December 20, 2010 4:05 PM | Report abuse

Ezra: Why is Reid satisfied with only 19 nominations being voted on this fall and winter?

Posted by: paul65 | December 20, 2010 4:07 PM | Report abuse


Sorry about this OT post....

Why is Rove "advising" Sweden about the Assange matter?

Is Rove there on behalf of soon-to-be- Congressional GOP leaders to try to compel Sweden to act according to their desires?

I can't imagine why else a liberal country would permit troublemakers like Rove to interfere in their affairs.

Wasn't Rove the same guy who was in Georgia advising them about Georgian-Russian affairs just as Russia decided they had enough of the nonsense and invaded Georgia?

Why haven't you been more vocal about the wikileaks issues? And the Assange trouble in Sweden, which looks like a a frameup? Doesn't this all relate to free speech and journalistic freedoms, which in turn relates to your chosen career?

Can we assume your silence on the matter means something? Fear? Or maybe agreement that the US should be heavy handed with Assange?

Posted by: lauren2010 | December 20, 2010 4:07 PM | Report abuse

Another OT post....

The FCC is about to vote to either change or preserve the way the Internet works.

Hey Ezra, what's the inside scoop on this?

You, as a blogger should have hawk eyes on this matter. Will the new rules preserve the internet or change it in ways we don't yet imagine?

Posted by: lauren2010 | December 20, 2010 4:11 PM | Report abuse

Scratch my last comment because Facebook would be ill advised to have an upgrade of "like" called "love" button... too suggestive. I still love this blog about MA market though.


Posted by: chrisgaun | December 20, 2010 4:18 PM | Report abuse

@paul65"Awesome website. If every American had access to such choices, no Congress could never take them away."

I believe that under the Massachusetts plan, this reader isn't eligible to participate in the exchanges because they receive their health care through their employer.

This is identical to the provisions in the ACA. These exchanges only apply to the individual market, which was a big difference between the ACA and Wyden-Bennett.

Posted by: jnc4p | December 20, 2010 4:26 PM | Report abuse

Hey paul65,

The documentation for my health care plan is on a secure website, but I would be more than happy to email them to you. Just post your email address.

Posted by: cummije5 | December 20, 2010 5:37 PM | Report abuse

We are spoiled here in Massachusetts.

We have something that is absent in many other states, and that is decades of good regulation and a good relationship with its insurers that ensure honorable behavior by the companies, gives them a fair return, and keeps costs down.

Of course it is expensive. Massachusetts is also one of the wealthiest states, but the burden is catching up to us, it does not "pay for itself".

The problem with comparing is that there is no way that an ordinary user can look over websites and know whether he will be covered for a major expense. Maybe with a team of lawyers who specialize in health care contracts, you could figure it out. All we can compare is a few gross categories that are cited by the company and of course the bottom line cost which can be misleading.

Many people live in a fools paradise -- they believe that their low-cost insurer who has paid a couple of bills of a few thousand dollars for them will be there to pick up a really expensive bill that would ruin them.

Administration promises for so-called ObamaCare which some compare to Massachusetts will have to be seen to be believed. The Congressional Budget Office is notorious for underestimating costs, not because its estimates are dishonest, but because ideal theoretical models never work ideally in practice.

Be assured that ObamaCare will not be the same as Massachusetts. If you want something that works like Massachusetts, have as good a tradition of regulation, be as wealthy as Massachusetts, have outstanding medical colleges that staff our local hospitals, have hospitals that are not hundreds of miles from you like they are in the Midwest and are not in our tiny state, and even with all that, our hospitals have changed their policies after losing tens of millions of dollars yearly about seven or eight years ago. After eight years of caring for my mother, the hospital care she got in 1998 was not the same in 2006.

Posted by: Leeskyblue | December 20, 2010 7:15 PM | Report abuse

--*Hey Ezra, what's the inside scoop on this?*--

Klein thinks "journalism" is too important to be left to the private market. Does that give you a clue?

Posted by: msoja | December 20, 2010 8:48 PM | Report abuse

I dont feel like i should be forced to have health insurance, I think everyone would like to have health insurance if they could afford it. If you need affordable health insurance search online "Wise Health Insurance" you dont want to be with out insurance any time.

Posted by: williamstaerk | December 21, 2010 2:31 AM | Report abuse

MA reader isn't Jon Gruber by chance??

Posted by: bmull | December 21, 2010 4:37 AM | Report abuse

I am soooo glad I found "Hypersonic Weight Loss"! I never knew planning and eating the many choices of meals could be fun.

Posted by: attincus | December 21, 2010 5:40 AM | Report abuse

The web site might be pretty to look at (I don't think so but that's in the eye of the beholder). But I am an actual customer of the Exchange/Connector and I can tell you from experience that the Connector is without a doubt the worst ecommerce site I have ever dealt with. You have to keep entering the same data over and over again, you can only compare up to three policies, it is totally developed for those getting their insurance for free (80% or more of its users), and so forth. You cannout use it without having to call the boiler room, the defintion of a bad web site.

And for all you Mass. residents fawning over it -- FYI -- the site was developed and is run by a company in Texas. Sending our tax dollars out of state. Isn't that the frosting on the cake?

Posted by: byrondennis | December 21, 2010 7:43 AM | Report abuse

I am impressed by a similar website offered for Medicare recipients -- (
Not only does it provide a list of all plans and associated premiums offered in your area, but, for Plan D prescription drug users, you can plug in your medications and dosages and it will array all of the offered plans in terms of estimated annual cost -- plus a consumer satisfaction rating of each plan. To me, this is how we get a handle on the cost of health care.

Posted by: kantcould | December 21, 2010 11:16 AM | Report abuse

a very nice site. There are still the normal issues of having the general public understand things like creditable coverage, qualifying events etc but this goes light years past anything else we've seen anywhere else.

it really is the travelocity of purchasing healthcare. Now if it was only affordable.

Posted by: visionbrkr | December 21, 2010 2:20 PM | Report abuse

"There are still the normal issues of having the general public understand things like creditable coverage, qualifying events etc"

No, those aren't "normal issues". They're only "normal issues" to a professional middleman who swims in jargon and insists that everyone else in the process is stupid, craven, greedy or some combination of the three.

"Creditable coverage" and "qualifying events" and the rest of visionbreaker's argot need to go away. That's when I'll declare victory.

Posted by: pseudonymousinnc | December 21, 2010 2:52 PM | Report abuse

--*"Creditable coverage" and "qualifying events" and the rest of visionbreaker's argot need to go away.*--

Hey, you little fascist, why not threaten him with the IRS?

Posted by: msoja | December 21, 2010 7:01 PM | Report abuse

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