Constitutional amendment would mandate health insurance for all residents

By Associated Press Tuesday, April 6, 2004


BOSTON - A proposed constitutional amendment mandating that lawmakers provide medical insurance to all Massachusetts residents is pitting health care advocates against business leaders, with critics warning the plan could let the state's highest court dictate coverage.

Under the amendment, lawmakers would be required to “enact and implement such laws as will ensure that no Massachusetts resident lacks comprehensive, affordable, and equitably financed health insurance coverage for all medically necessary preventive, acute and chronic health care and mental health care services, prescription drugs and devices.”

Backers say the amendment will force lawmakers to come to grips with the state's looming health care crisis.

“Some say we cannot afford the cost of covering the uninsured, but we are already paying for the much higher costs of failing to provide health care to those who need it,” said Dr. Peter Slavin, president of Massachusetts General Hospital.

Critics say they sympathize with the goal of universal health care, but believe amending the state constitution is the wrong way to accomplish it. They point to Maine, which is trying to accomplish a similar goal legislatively rather than using a constitutional amendment.

Foes say their biggest fear is that, once the constitution is amended, the question would end up before the state Supreme Judicial Court, which would be forced to decide what is meant by “medically necessary” services or “comprehensive” health care.

“This amendment is not necessary. It is a statement of a goal that we all share ... but it doesn't get us any closer to that goal,” said Bill Vernon of the National Federation of Independent Business. “It leaves it up to the courts to decide what is affordable.”

Critics also say the amendment doesn't say who will pay for the extra coverage.

That price tag could be as high as $3 billion if the state were to provide a $5,000 insurance plan for each of the state's 600,000 uninsured people, said Eileen McAnneny, vice president of government affairs for Associated Industries of Massachusetts.

Some business owners support the proposal.

Anne Shuhler owns a copy shop in Cambridge with 15 employees and spends about $300 a month per employee on health insurance, up from about $185 five years ago.

“I am paying as much for health insurance as I do for the leases on my copying machines. It's running my business,” said Shuhler.

At a Statehouse hearing Tuesday, some lawmakers said they were skeptical about the plan.

“If this becomes part of our constitution the Legislature will be forced to come up with some solution and when they do, it's going to be taken to the SJC and the SJC is going to mandate it,” said Rep. William Galvin, D-Canton.

But backers defended the language, saying they wanted to give lawmakers as broad a range of options as possible to respond to the amendment's mandates.

“These terms are intended to be general enough for lawmakers to define them in the zone of reasonableness,”said Carl Valvo, a lawyer for the Health Care for Massachusetts Campaign, which is pushing the amendment. “Specificity in legislation is fine. Specificity in the constitution is less desirable.”

Like an amendment banning gay marriage, the proposal would need to be approved by the current Legislature and again by the new, two-year Legislature that takes office in January before reaching votes.

But unlike the gay marriage question, which must get the backing of 101 lawmakers in both sessions, the health care question only needs the backing of 50 lawmakers in both sessions. Because the health care question is the result of a petition drive it faces a lower threshold than the gay marriage question, which was filed by a lawmaker.

The soonest either question could appear on the ballot is November, 2006.

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