The uninsured let a deadline pass

Massachusetts required them to get health insurance by July 1, but two-thirds haven't yet complied.

from the July 2, 2007 edition

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To some, July 1 may have been just another quiet Sunday. There are people who don't watch the news, attend community events, or listen to rules, says Shirley Dorsey of Boston's Roxbury neighborhood. She can think of several friends and family members who could qualify for state-paid care but haven't gotten it – including her sister. So she gave three community volunteers her sister's phone number to prod her into action.

Individuals who are informed know they can afford to wait: Though July 1 was the deadline for coverage, a $219 penalty doesn't kick in until Dec. 31. Sunday was like a warning bell.

"It's the day the door opens, but it's not the day the door closes," says Jonathan Gruber, a board member at the connector authority and a health economist at the Massachusetts Institute of Technology in Cambridge, Mass.

Meeting the deadline doesn't determine the plan's success according to public officials and healthcare analysts. Just getting a majority of subsidized people into the system has benefited new enrollees and the state, some say.

About 70,000 people moved to Commonwealth Care from the "free care" policy, in which the state helps foot hospital bills directly. Now, the government will start contributing to their monthly premiums instead – and save a lot of money.

"You get subsidized people, and that takes pressure off the free-care pool," says Mr. Powers.

The key to keeping premiums low is to bring young, healthy adults on board, whether they're subsidized or not, explains Robert Blendon, a professor of health policy at the Harvard School of Public Health in Boston. They'll help offset costs because they seek less medical attention than others do.

They're also the largest demographic of the uninsured in Massachusetts. Bay State residents ages 18 to 34 are half as likely to have health insurance as any other age group, the Urban Institute reported in 2005. Some young adults resist paying into a healthcare pool because they're least likely to take from it. The connector authority hopes to persuade them that the security of having insurance is worth the cost. People buy auto insurance, the reasoning goes, and humans are much more valuable than cars.

Brooks, who hasn't had healthcare since quitting his city job in 2000 to open a small eatery in Cambridge, Mass., appreciates the analogy. But he says, "Things are still tight," he admits. "It's just hard to find a good plan."

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