Guest Blog: The Dog that Didn’t Bark: The Individual Mandate in Massachusetts

  ·  Health Policy Hub

This is a guest post from our partner Health Care for All in Massachusetts. 

Republicans have called it the end of liberty in America. Santorum said it would "crush freedom." Yet here in Massachusetts, the individual mandate is just part of the landscape, helping moderate health costs and providing health coverage to almost everyone in the state.

When the individual mandate, championed and signed into law by Governor Mitt Romney, was implemented for the 2008 tax filings, we called it the “dog that didn’t bark.” For the first time, people had to indicate on their tax returns whether they had health insurance. If they didn’t, there was a penalty assessed on their taxes.

Were there riots? Big protests? Angry town hall meetings? Online fury? None of the above. The individual mandate was calmly accepted as a proper tradeoff for extending coverage to everyone.

To be honest, I was prepared for some backlash. I was hoping that when the time came, it would be great if at least three-fourths of Massachusetts residents filled out the mandate tax forms properly. I was bracing myself for lots of people leaving the new “Schedule HC” (for health care) form blank on their state tax forms. Instead, that first year the Department of Revenue reported that 98.3 percent of filers correctly filled out their forms.

Since then, the individual mandate has become an accepted part of civic life. Even with all the national attacks, the dog still hasn’t barked. Polls in Massachusetts show continued widespread support for the state’s health reform law. With more than 98 percent of people covered, with more businesses than ever offering health insurance to their workers, and with health costs growing more slowly than the rest of the country, it’s clear why there is strong support.

It’s telling that not a single legislator over the past six years has even introduced a bill to repeal our mandate. So it’s not surprising that when a group tried to pass a ballot initiative last year to repeal the individual mandate, they could not get even close to enough signatures to put it on the ballot. In fact, the group had only 43 "likes" on their Facebook page, out of an entire state of 6 million (almost all on Facebook, it seems).

There’s no doubt that health reform is, in the Vice President’s words, a BFD. But for the lucky people of Massachusetts who have an individual health coverage mandate in effect, it’s really not that big of a deal at all.

 -- Brian Rosman, Research Director Health Care for All