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Massachusetts Mandatory Plan

Comparison: MA Law, U.S. Law, and
single-payer health care, Improved Medicare for All

This is Part 1 of 2 about the Massachusetts health care law.

The U.S. health insurance law, the Affordable Care Act of 2010 (called "Obamacare"), is very similar to the Massachusetts law, as indicated by the words in red. — Position at table.


Massachusetts Law
(manadated health
United States Law:
Affordable Care Act
(mandated health
Improved Medicare
for All

(national single-payer
health care)
When signed into law:   
April 2006
March 2010
The legislation is not yet being debated, so it is not in effect. It would replace the other two laws.
Already implemented,
so we can refer to the results documented in this web page.
Implementation started, but …:
will continue from now through 2015 plus one provision starting in 2018.
The year of implementation would be determined by the final version of the legislation.
A primary objective is to bring costs under control:
Yes, but it HAS NOT.

The law has caused a dramatic increase in costs, as indicated in the articles in Part 2 of 2, linked below.
Yes, but it WILL NOT.

An increase of costs is projected by government auditors to cost over $300 billion within the first ten years.
No, but it WILL.

The primary objective is to provide health care for all.

But there is a dramatic decrease in costs that occurs automatically.
The primary objective of a health-care-for-all system is to cover everyone; 100%.
The simplicity of coverage for all automatically results in efficiency that provides massive cuts in costs: over $400 billion per year, every year: over $4 trillion over the first ten years.
Does the law help anyone? Yes, at a horrible cost to Americans and America:
— A worsening of the already sky-rocketing heatlh insurance costs.
— An increase in our tax burden for Americans and America.
— Intrusions on Americans' lives.
Yes, at a horrible cost to Americans and America:
— A worsening of the already sky-rocketing heatlh insurance costs in parallel with helping a seemingly significant, but relatively very few Americans. The latter help is well-advertised via the spending of millions of our tax dollars.
— An increase in our tax burden for Americans and America. There are a little over 600 reasons in the law that taxes will increase.
— Intrusions on Americans' lives.
Yes, but it helps everyone, both all Americans and all of America.
Does the law increase jobs in the private sector?
Some businesses moved out of Massachusetts to escape the law.
The U.S. economy will be hurt by this law. That means a continued loss of jobs.
The United States will be more globally competitive. That means increasing jobs, recovering jobs and saving jobs.
This will be true across all industries, but especially for all jobs related directly and indirectly to health care.
Does it provide access to health care for everyone?
No. An incredibly high number of Americans are left without health care access (insurance):
over 23 million:
23,100,000 citizens!
Access to health care is automatic for all.
Everyone automatically is covered by one cost-efficient plan.
Insurance exchanges, where you can review your options for purchase of health insurance:
Effective in 2014.
We’ll save money by not maintaining exchanges.
“Individual Mandate”:
Forces/mandates the purchase of health insurance:
Effective in 2014.
Not applicable. Instead of being forced to pay sky-rocketing premiums, there will be a few percent increase in the Medicare payroll tax on earned income. No more co-pays, deductibles or coinsurance like the MA law of 2006 and US law of 2010.
A tax penalty
is charged if a person does not purchase health insurance when required to do so:
Effective in 2014.
No. It will not be necessary to purchase health insurance, as indicated above.
Automatic government assignments of people to plans.

They are mandated/forced to have coverage under the assigned plan.
Instead of low-income citizens deciding on how they want health insurance coverage, including whether or not to be on Medicaid, they are forced by being automatically assigned to Medicaid. That includes being forced into the federally-required estate recovery program (OBRA 1993) that affects all Medicaid members in all states who use Medicaid benefits while they are age 55 and older. [Note: all Medicaid members, not just those who are in nursing homes.]
Same as Massachusetts law but expanded by expanding to all U.S. citizens, by raising previous income limitations and age, by allowing childless adults into the plan and by dropping the asset test.
Automatic assignment of an insurance plan to an employee also will occur for employers with more than 200 employees.

Effective in 2014.

Some employees will be automatically assigned (forced) to pay for a plan for which they never signed up themselves.
The details are to be defined by the Secretary of Health and Human Services.

The forcing that occurs here is the absolute best situation, as indicated by the benefits above of lower costs, more jobs, as well as better health that naturally results from having everyone covered, everyone being able to get health care.

All citizens will be automatically covered by one excellent plan at a significantly lower cost and excellent benefits.

August 16, 2010 regarding Massachusetts:
“Massachusetts’ struggle to make “universal health insurance” work continues to be an excellent peek at what the entire nation faces when ObamaCare kicks in – and the picture remains ugly. … … Health care now consumes 35 percent of the state budget, up from 22 percent in 2000. (Massachusetts Governor) Patrick recently asked Washington for $473 million to help make the Massachusetts reform work – on top of the $1.2 billion in support the feds have already kicked in over three years, more than $3,000 per person in the state.” — New York Post

Contents of this web page

Above: Side-by-side comparison (See above.)


Below: About the Massachusetts Law
      Note: All the facts about this failure will continue to unfold in the coming months and years.
Also see:
       Additional Information for links to even more articles and information … and to Part 2 of 2

United States

About the U.S. law: the Affordable Care Act of 2010
       See Obamacare and follow the links.


About the Massachusetts Law

Overall Description of the MA Law from the perspective of Massachusetts citizens

State government forcing citizens to purchase private health insurance plans. — The state of Massachusetts implemented a mandatory health insurance plan for the state in 2006. The state government forces every citizen to purchase health insurance from a health insurance company unless their income level fits within the eligibility requirements for a subsidized plan.

The Mandate and Impact — If a citizen is not eligible for a subsidized health insurance plan and does not purchase health insurance, then they owe a fine that is due as part of income taxes due on April 15 of each year. If the fine is not paid, then the citizen is guilty of tax evasion.

Subsidized Plans and Impact — If a citizen is eligible for a subsidized health insurance plan, then they are assisted by the state to help pay the for-profit health insurance company. As part of registering for that assistance the citizen then is obligated to the state under what is called “estate recovery.” When the assisted person dies, the state becomes a first-priority claimant over all monies and properties. The state, therefore, recovers as much as it determines is owned to the state from the assistance that was provided.

Rationing and the Impact — Any citizen who participates in a subsidized plan is subject to rationing via the fact that many physicians in Massachusetts have decided to not treat those citizens. As a result, these citizens use the emergency rooms more often for their health care.

High Cost — The overall cost has been much higher than anticipated by the creators of the mandatory health insurance law.

Additional Information

About the U.S. law, the Affordable Care Act of 2010: See Obamacare and follow the links.


Know what Massachusetts really wants ... by the votes of over a quarter of a million citizens ... and growing at each general election every two years, documented at the Massachussets web page.

Clarification about the Medicare Payroll Tax. The reference to the Medicare payroll tax in the comparison table, above, is made because most Americans will see their contribution to Improved Medicare for All be mostly or only via that tax. For more information about the proposed sources of revenue refer to Costs and Savings.

Grim Prognosis for Massachusetts Reform

National Lessons from State Health Reform: The Massachusetts Case Study – about 20 minutes of video presentation by Dr. David Himmelstein

Financial impact of the March 2010 U.S. law.

Benefits of Improved Medicare for All.

Part 2 of 2

Part 2 of 2 Massachusetts Law Articles

We Do Not Want Mandated Insurance

We Want the Peace of Mind
of having NO Major Medical Bills


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