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Mandatory Health Insurance: Lessons from Massachusetts

As we reported in May 2007 , the TCF “implementation” deadline tested whether firms were implementing necessary changes in a substantial part of their business. Firms were expected to have allocated appropriate resources and responsibilities, developed plans and processes, and created capability to meet the TCF principle. We would expect a firm’s implementation plan to identify and tackle any gaps in their ability to ensure customers are treated fairly, including the designing and selling of PPI. We have set firms a deadline of December 2008 to complete their work on TCF and to demonstrate they are consistently treating their customers fairly in all aspects of their business, including. | Mandatory Health Insurance Lessons from Massachusetts Craig J. Richardson What lessons can be learned from the implementation of mandatory health insurance As the Obama administration contemplates enacting far-reaching health care reforms that increase the role of government the case of Massachusetts is worth serious study. Massachusetts three-year experiment with mandatory health insurance known as Chapter 58 legislation has been judged by some health economists to be a qualified success since it reached a primary goal of lowering the number of uninsured in the state Gruber 2009 Long and Masi 2008 . On the other hand Tanner 2008 5 argues that previously uninsured citizens signed up for health insurance because it was free or heavily subsidized not because of the mandate itself. Official state statistics claim the number of uninsured in the state dropped from 11 percent in 2005 to less than 3 percent in 2009 Massachusetts Health Connector 2009 . Tanner 2009 disputes this number and suggests the number is closer to 5 percent using Urban Institute and Census surveys as evidence. What supporters and foes of mandatory health insurance both seem to agree on is that the number of uninsured has fallen in the state since Chapter 58 and yet there remain between 150 000 and 200 000 uninsured citizens. Unlike a market-based solution which would shrink the role of government while enhancing individual choices Massachusetts Cato Journal Vol. 29 No. 2 Spring Summer 2009 . Copyright Cato Institute. All rights reserved. Craig Richardson is Associate Professor of Economics at Winston-Salem State University. He thanks Michael Cannon for many helpful comments. He also thanks the American Institute for Economic Research in Great Barrington Massachusetts for supporting this research through a 2008 Research Fellowship. 335 Cato Journal mandates that individuals purchase health insurance and it uses the carrot and stick approach. First the state legislature created the Commonwealth Care