Lawmakers give early approval to comprehensive health care ballot question

Erik Arvidson, Fitchburg Sentinel & Enterprise, July 15, 2004

Boston - Every Massachusetts citizen would have a constitutional right to access affordable, comprehensive health care under a ballot question given initial approval on Wednesday by state lawmakers.

The House and Senate, meeting in a Constitutional Convention, voted 143 to 41 in favor of the proposed constitutional amendment, which still must be approved again by another joint session of the Legislature and by the voters.

Proponents noted that 1.5 million Massachusetts residents under 65 were without health insurance at some point in 2003, and that number may grow as private health care plans become more expensive.

"We're trying to provide justice in health care so that every single citizen has a health care plan," said Sen. Steven A. Tolman, D-Boston.

The language of the ballot question does not specify the details of how the state would implement a system that would provide health care to every citizen. It only makes it the obligation of the governor and the Legislature "to enact and implement such laws, subject to approval by the voters at a statewide election, as will ensure that no Massachusetts resident lacks comprehensive, affordable and equitably financed health insurance coverage."

That means that if the ballot question were approved next year, it would go before the voters in November 2006. If the voters approve it, lawmakers would have to create a new health care system that would go before the voters again, in November 2008 at the earliest.

Opponents said that embedding such sweeping language into the constitution would invite lawsuits against the state among people dissatisfied with the quality, or cost, of their health care.

Rep. Colleen Garry, D-Dracut, a member of the Health Care Committee, said she voted against the universal health care question because she is concerned Massachusetts will be saddled with the high cost of insuring the sickest patients who will come here for their care.

"I honestly believe that this is something that has to be a national issue, that it can't be a state-by-state issue," Garry said. The goal of guaranteeing affordable health care to all citizens is laudable, Garry said, and she cited steps the state has taken to improve access to health care for children, the elderly, and the poor. But Massachusetts can't go it alone, she said.

She said that people and employers in her district, especially in towns bordering New Hampshire, struggle to remain competitive despite the high cost of doing business in Massachusetts.

"I think we're also more skeptical than others of the ability of this state to unilaterally solve a problem like universal access to health care," Tucker said. "I'm going to support this because I want the issue to proceed. I want the issue to come to the table."

Tucker added that the amendment "respects the intelligence of the voters" because it would allow voters to get a cost estimate and see the entire plan before they vote on it. "It will force the process even more. People will come to the table with an actual plan and put pressure on people to address what we already know is a serious problem," Tucker said.

John McDonough, executive director of Health Care For All in Massachusetts, said his organization was pleased the amendment passed, but was "not happy" that it required a final referendum by the voters after a system is created.

"There already exists an ability for the voters under the referendum process to require an up or down vote on anything the Legislature does. This adds a rather significant obstacle to make it much harder to actually achieve the goals as proposed," McDonough said.

McDonough added that there are "several paths to get to universal health care, some more expensive than others," but that the cost of not providing health care to all citizens was much higher.

"The challenge is that none of us can be sure how real this is because it's subject to action not just by future legislators, but the voters, as well as further review by the courts," McDonough said. "There are too many hurdles to say how positively or negatively this will turn out."

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