Massachusetts Considers Imposing Statewide Single-Payer Health Care System

Published June 23, 2016

Massachusetts lawmakers are considering two bills that would institute a statewide single-payer health care system.

Senate Bill 579, “an act establishing Medicare for all in Massachusetts,” was heard by the Joint Committee on Health Care Financing on March 2 and remains in committee with its counterpart, House Bill 1026. Combined, the bills are cosponsored by 54 Democrats. No Republican lawmakers agreed to cosponsor either bill.

For a single-payer system to take effect in 2016, lawmakers would have to pass the bills before the Massachusetts General Court adjourns on July 31, 2016, and the legislation would then have to be signed by Gov. Charlie Baker (R).

Could Reduce Access, Quality

Amy Lischko, a senior fellow at the Pioneer Institute for Public Policy Research and associate professor at Tufts University School of Medicine, says adoption of a single-payer health care system would reduce access to quality health care in the state.

“Quality and access currently are not significant problems in the Massachusetts health care system,” Lischko said. “It’s the cost of care that is problematic. My guess is that implementing a single-payer system would negatively affect quality and access, at least in the short run.”

Bad for Business?

Bill Vernon, state director of the Massachusetts branch of the National Federation of Independent Business, says a single-payer system could drive up health care costs while raising taxes small business owners already can’t afford.

“I think small business owners are concerned about having more government involvement and the additional higher costs—higher taxes to pay for it all,” Vernon said. “Health insurance costs are very much up there with the threat of lawsuits as being at the top of business owners’ concerns.”

Romney’s Cautionary Tale

Under former Gov. Mitt Romney (R) in 2006, Massachusetts implemented an individual mandate requiring residents to buy health insurance or pay a fine, a stipulation Congress included in the Affordable Care Act President Barack Obama signed in 2010.

Vernon says state and federal health care interventions have failed to produce the financial savings their proponents promised.

“What I wish is that people would learn from the Massachusetts experience with health care reform,” Vernon said. “I think we’ve seen that universal coverage, or near-universal coverage, hasn’t resulted in the kind of savings that were predicted in the past.”

Access to health care providers, reductions in taxes to pay for uncompensated care, and decreased use of emergency rooms for non-emergencies have fallen short of health care reformers’ projections, Vernon says.

“We were told that the use of emergency rooms would go down, and people would have their own doctor. That didn’t happen,” Vernon said. “We were told [taxpayers’] costs for uncompensated care for providers would go down. That [promise] hasn’t been kept.”

Health Care Already Expensive

Seventy-five percent of the state’s 200,000 uninsured residents cited high costs as their reason for lacking health insurance coverage, according to a February report by the University of Massachusetts Medical School, which was commissioned by the Blue Cross Blue Shield of Massachusetts Foundation.

Lischko says there are much less damaging ways for Massachusetts lawmakers to curb the state’s high health care costs.

“Health care costs have always been higher in Massachusetts compared to the rest of the nation, mostly reflecting our reliance on expensive academic medical centers for care that could be treated in high-quality, affordable community hospitals,” Lischko said.

Vernon says under a single-payer system the costs of health care would rise because demand naturally increases more rapidly than the supply of health care providers.

“Utilization would probably go up, not down, and costs would go up, not down,” Vernon said.

Other States Decide

Vermont lawmakers abandoned their pursuit of a statewide single-payer system when Gov. Peter Shumlin (D), who had supported the idea, announced it carried too high a “risk of economic shock,” Health Care News reported in December 2014.

Colorado voters will decide by ballot initiative in November 2016 whether to adopt a single-payer system.

Ben Johnson ([email protected]) writes from Stockport, Ohio. Luke Karnick contributed to this story.

Internet Info:

Matthew Glans, “Single-Payer Is Not Right for Colorado or Any State,” Heartlander, The Heartland Institute, May 11, 2016:

Michael McGrady, “Colorado Single-Payer Health Care Amendment Goes to Ballot,” Health Care News, The Heartland Institute, May 2016: