With court challenges to federal health reform heating up, Ezra Klein, a god-like wonk at The Washington Post, told readers this weekend that it was time to check in on Massachusetts. How are we faring with the mandate that requires everyone to be insured?
Very well, he concludes. More than 98 percent of residents are insured, and the system does all right in the polls.
Read his whole piece here, but here’s an excerpt:
Like the federal law, the Massachusetts law left most people’s health arrangements alone. The exception: people who don’t get their coverage through a large employer or a public program. That accounts for most of the uninsured. It’s also where the individual mandate is primarily in play and where the “exchanges” – the purchasing markets that put individuals and small businesses in a single pool and force insurers to compete for their business and treat them fairly – really matter.
In Massachusetts, that market has worked better than expected. According to data from America’s Health Insurance Plans, the largest health insurer trade group, premiums for that market have fallen by 40 percent since the reforms were put in place. Nationally, those premiums have risen by 14 percent.
There are a couple of reasons for Massachusetts’s success. One is that the market is more transparent, and so insurers are competing more aggressively against one another. Jon Kingsdale, who ran the new health-care market, notes that the lower-cost plans have been much more popular than the higher-cost plans. The bigger reason is that the individual mandate – plus the combining of individual and small firms in the same insurance market – brought healthier, younger people into the mix, which brought average premiums down for everybody.