UHC COMES TO...

UHC COMES TO MA. We've got a meeting in a few minutes, so I've got to make this quick: Yesterday, Mitt Romney signed a bill bringing universal health care to Massachusetts. The state will now have an individual mandate, subsidization for low-income workers, and a minor penalty against employers who don't offer health benefits. In order to pass the program -- and make no mistake, "solving" a state's health care crisis is an achievement massive enough to anchor his 2008 presidential campaign -- Romney had to negotiate with a Democratic legislature and a powerful, long-standing statewide lobby for universal health coverage. And so he did. This was a compromise bill, not a Republican one.

What emerged, while not glorious, is a distinct improvement on the status quo. Single adults making less than $9,500 will receive free care with no deductible, those netting up to 300 percent of the poverty line ($48,000 for a family of three) will be subsidized on a sliding scale, and individuals with the resources but not the willingness to purchase health care will be fined about a $1,000 annually, presumably through taxes. The bill has no dedicated funding source, so there's a certain amount of apprehension over its implementation, but look for it to get the money it needs -- not only does the cash exist, but Romney desperately wants to tout this achievement in 2008.

The program also boasts a serious pay-for-performance element, so there's some actual innovation in the structure that could prove an interesting test run for future P4P systems (for more on P4P, see this book review of mine). All in all, it�s interesting stuff. And if he wasn't there already, look for Romney to immediately leap into the top tier of Republican presidential contenders -- this sort of bipartisan compromise and executive BigThink is exactly the sort of thing the David Broders of the world go nuts for.

Update: Apologies, David, in comments, reminds me that Romney has simply said he will sign it, but he's not physically put pen to paper yet. That was a silly oversight by me, the sort of thing normally caught by the squad of ace factcheckers we employ at the magazine. To see our pieces filtered through their handiwork is to touch the face of transcendence, and the best way to do that is to subscribe.

--Ezra Klein

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