Universal Healthcare in the Bay State

UNIVERSAL HEALTHCARE IN THE BAY STATE….Several emailers want to know what I think of the new Massachusetts universal healthcare legislation. Answer: I’m not sure.

As near as I can tell, the main point in its favor is that it’s something. It’s progress just to have a state pass any universal healthcare legislation at all, and it’s a good example of a state acting as a laboratory for a new idea.

At the same time, the plan itself is a fairly unattractive kludge that, in essence, extends Medicaid to more people and levies a small fine (in the form of higher income taxes) on anyone who doesn’t have health insurance but could afford to buy it. This doesn’t do anything to address cost containment and doesn’t do anything to make the system more efficient.

What’s more, as several people have pointed out, Massachusetts is in a very unusual position: they have such a small uninsured population that they were able to pass their plan with almost nothing in the way of new taxes to fund it. There are very few states that are in this position, which makes the plan’s usefulness as a model limited. On the other hand, I think Jon Cohn has an incisive take on the political ramifications:

Nationally the most important impact of this new law may be on politics, not policy. Once [governor Mitt] Romney starts boasting about how he achieved universal health coverage in Massachusetts, it will become that much harder for conservatives to demonize the very concept as “big government.” Oh, they’ll try ? and they’ll have at least some success. But now Democrats will have this retort: If a Republican governor and leading presidential contender with strong conservative credentials thinks universal health care is a good idea, how radical an idea can it be?

That’s right. If Romney runs, he’s going to make universal healthcare a major plank in a Republican campaign. Even if he loses, that’s a huge step.