Additionally, the health insurance mandate has, thus far, resulted in a high concentration of old and sick people taking advantage of expanded government insurance programs, rather than a significant broadening of the risk pool for those expanded programs. According to an April Boston Globe report:
More than 110,000 people -- one-fifth to one-quarter of the state's uninsured -- have been given free or heavily subsidized coverage in the past year. ...A major expansion of government insurance for the oldest and sickest without a major change in the risk pool being covered statewide was not the goal of mandatory health insurance. Obviously, it is too early to draw any firm conclusions about the Massachusetts experiment, but it's still worth looking very closely at their developing experience with trying to implement a mandate, especially after the fines for failing to buy insurance start kicking in this summer. There is a lot to recommend mandates in theory, but it's the implementation that will tell us whether or not such an approach is something Democrats ought to uniformly push to replicate nationwide.The biggest strides so far have been in providing free coverage for the uninsured with low incomes. Nearly half of that group has been signed up for the state Medicaid program or for new fully subsidized plans that offer some of the most comprehensive benefits in the nation. Earlier this month, the state expanded subsidies to provide free insurance for tens of thousands more.
"The very poor are covered very well," said Brother Jack Rathschmidt of Our Lady of Lourdes Catholic Church in Jamaica Plain, a leader of the Greater Boston Interfaith Organization, a coalition of 80 congregations....
So far, most of those enrolling in partially subsidized programs are older and sicker. Without the younger, healthier people, costs will rise rapidly and the plans could quickly become unaffordable for everyone. (emphasis added)
--Garance Franke-Ruta
