Editorial: Looking for a solution

Monday, July 9, 2007 | 7:11 a.m.

A week ago Massachusetts became the first state to require that its residents have health insurance or face financial penalties.

In making such coverage mandatory, proponents also hope to make health insurance more affordable to the state's 6.5 million residents, thereby decreasing the number of people who obtain expensive, and often uncompensated, emergency room care.

This bold approach is being dissected and discussed as such states as California, Illinois and Pennsylvania consider similar options.

The Massachusetts program required the support of public and private health officials, lawmakers, private health insurers, consumer advocates and employers. If it works, the program could become a model for reforming a health care system that, nationally, is too cumbersome, too expensive and inaccessible for too many people.

Massachusetts residents must certify that they obtained health insurance coverage by the end of 2007 when they file their state income tax returns. Those who fail to do so will lose the state's $219 personal exemption. They face larger penalties with each subsequent year that they fail to obtain coverage.

To help residents comply, the state is subsidizing insurance with no deductible for people whose incomes are at or below 300 percent of the federal poverty level. Premiums are determined on a sliding scale. The poorest residents pay nothing.

The system already has one glitch. The Washington Post reported last week that about 60,000 residents may be exempted from penalties because they cannot afford private insurance, and their incomes are too high to qualify for state-subsidized coverage. So people struggling to make ends meet while living just above the government-approved poverty level still may fall into a coverage gap.

But at least Massachusetts is trying. Gov. Jim Gibbons and the Nevada Legislature this year failed to take any significant action to ensure health insurance for the estimated 450,000 Nevadans who lack coverage. More than 100,000 of these uninsured are children.

It will be interesting to see how well Massachusetts' new law progresses. Our nation desperately needs some new ideas - and the courage to try them - if we are to solve the health care access crisis we face.