Even if Approved, Massachusetts Lawmakers May Not Implement Universal Health Measure
Question 5, the Massachusetts ballot initiative that would "mandate universal health coverage and adopt tight HMO controls," may face alteration or inaction from the state Legislature if passed by voters next month, the Boston Globe reports. Some lawmakers are "worried that the sweeping ballot measure would throw the health care system into chaos" and "believe it contains a plethora of legal flaws that would allow [the Legislature] to ignore or invalidate substantial portions of it" (Mishra, Boston Globe, 10/28). The ballot measure not only would mandate universal health care but also would prevent further conversions of not-for-profit hospitals, HMOs and insurers to for-profit status, implement a patients' bill of rights by Jan. 1, 2001 and put a cap on insurers' administrative costs (American Health Line, 8/18). While "faring well in polls," much of Question 5's support has been eradicated by an expensive ad campaign by the HMO industry. Opponents are concerned that Question 5's enactment would increase health costs, strain HMOs and increase the number of uninsured. Legislators have focused their concerns on the ballot's mandate to form a commission to recommend implementation of a universal health care program by July 2002. As Legislature likely will have a different makeup in 2002 than it does now, some lawmakers contend that "[i]t is unconstitutional for one Legislature or even supporters of a ballot question to tell a future group of lawmakers what to do," according to the Globe. Richard Moore (D), chair of the Senate Health Care Committee and an opponent of the measure, added, "There's no penalty in Question 5 if we fail to follow it." Some observers believe that the Legislature will oppose the measure in inverse proportion to the percentage of the vote it gains: "It's very difficult to change in any substantial way an initiative approved by voters. The mandate of voters carries enormous political clout," Mike Widmer of the Massachusetts Taxpayer Foundation said. Andre Guillemin, political director of Yes on 5, the group advocating passage of the measure, said they would continue their public campaign if the Legislature attempted to prevent implementation of Question 5. "We think that the people have the right to make their needs ... heard" in the state capitol, Guillemin said, adding, "The Legislature, which is supposed to fulfill the will of the people, should uphold Question 5" (Boston Globe, 10/28). Meanwhile, four Massachusetts HMOs last week received an extension on filing "disclosure forms that reveal ... top executive salaries" until after the election on Nov. 7, the AP/Worcester Telegram & Gazette reports. The insurers contend that "the delay is necessary to complete their 1999 federal income tax forms," but Secretary of State William Galvin -- "an outspoken critic of HMOs" -- said they are "concealing [executive salaries] before the vote on ballot Question 5." In 1998, the heads of two HMOs earned "more than $1 million" in salary and compensation. "They are being asked to limit administrative expenses, yet for no good reason the reports ... that would detail salaries and benefits conferred on allegedly nonprofit administrators won't be filed until after the election," Galvin said. The HMOs contend it is not "unusual" to seek an extension on the disclosure forms (AP/Worcester Telegram & Gazette, 10.27).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.