FLORIDA HEALTH INSURANCE

November 29, 2007

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Health Insurance Troubles

They called it a landmark, a breakthrough, a model for the nation. But the Massachusetts health insurance plan is in serious trouble, which means taxpayers are in trouble, too.

WBZ has learned the program is already over budget by hundreds of millions of dollars. "I have medicine I have to take and it's nice to have in case you have to go the doctors."

Eric Towne of Westwood is one of 215,000 Massachusetts residents who now has health insurance because of the new state law. In fact, so many people have signed up, state leaders don't know whether to laugh or cry.

The response has been great, but the new price tag has lawmakers feeling sick. So what's wrong? Quite simply, the economy is worse today than when the legislation was written, so state revenues are way off, while the number of people seeking insurance is way up.

So just how big is this shortfall? It has been reported that the state needs another $147 million to pay for that larger than expected number of people looking for insurance. WBZ has learned the shortfall could as reach $200 hundred million, but according to sources, it might approach $400 million next year.

Steve Pangiotakos is the chairman of the Senate Ways and Means Committee. While he remains firmly committed to the new health care law a possible recession makes all programs tough to fund. "I think we are in a very cautious time frame here to see which way we are going."

WBZ has learned the Patrick administration is worried about those numbers. In the next 45 days, we are told they might review key parts of the program, including the higher co-payments and premiums. Even the program's supporters are anxious.

"The state of the economy is one of the major risks that could unbalance and it and create real difficultly in implementing it fully," said Health Care Advocate John McDonough.

And comments like that are making recipients like Eric Towne a little queasy.

And the insurance plan still hasn't reached its goal. It's estimated there are still more than 300,000 people who have not signed up for health insurance.

Define Health Insurance

Health insurance is a form of group insurance, where individuals pay premiums or taxes in order to help protect themselves from high or unexpected healthcare expenses.

Health insurance works by estimating the overall "risk" of healthcare expenses and developing a routine finance structure (such as a monthly premium, or annual tax) that will ensure that money is available to pay for the healthcare benefits specified in the insurance agreement.

The healthcare benefit is administered by a central organization, which is most often either a government agency, or a private or not-for-profit entity operating a health plan.

John Edwards View Of Health Insurance

Americans of means who fail to sign up for health insurance could find their wages garnisheed and their tax refunds withheld if John Edwards becomes president.

The North Carolina Democrat noted Thursday that under his universal health-care plan, every American would be required to have health insurance. He said people who couldn’t afford to pay the premiums would qualify for public subsidies or government health plans such as Medicaid. But he said people who could afford insurance would not be allowed to choose to go without.

“When somebody chooses not to be in the health-care system, then what they’re choosing is that the rest of America is going to pay for their health care,” he said in a meeting with Des Moines Register reporters and editors.

He said that if uninsured people have an emergency and wind up in the hospital, the taxpayers usually wind up paying for it.

“My health-care plan requires responsibility from everybody. The government’s responsible, the individual’s responsible, the workers are responsible, and the employers are responsible.”

Edwards said uninsured people would be enrolled in insurance plans whenever they used the health-care system or government services.

“So if you don’t have health-care coverage, and you go to the emergency room, you get enrolled. If you’re a 5- or 6-year-old and you go to kindergarten or sign up for school, you get enrolled, if you’re not on a health-care plan. If you go the library, you get picked up.”

Edwards did not give specific monetary amounts for the penalties he would impose on people of means who failed to sign up for insurance.

His comments came a day after a related dust-up between his two main Democratic rivals, Hillary Clinton and Barack Obama.

Obama’s health-care plan would not require adults to have health insurance, and he accused Clinton of not being specific in how she would enforce her proposed requirement that people who could afford insurance sign up and pay premiums.

Clinton has said that she would consider automatically enrolling uninsured people in insurance plans, but that she would work out enforcement details with Congress.

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