Cato Insitute

Executive Summary

Massachusetts has enacted one of the most far-reaching state health insurance reform packages in recent decades. Much attention has been focused on the act's unprecedented mandate that every resident obtain health insurance coverage. However, the act goes far beyond an individual mandate to radically change the way health insurance is bought and sold in the state. Many observers see Massachusetts's reforms as a model for the nation, but a closer look provides ample reasons to be skeptical. Among them:

• The individual mandate opens the door to widespread regulation of the health care industry and political interference in personal health care decisions.
• The act's subsidies are poorly targeted and overly generous.
• The Massachusetts Health Care Connector, which restructures the individual and small business insurance markets, is a form of managed competition that has the potential to severely limit consumer choice.
• The act imposes new burdens on business and creates a host of new government bureaucracies to manage the health care system.
• Health care needs more consumer control and freer markets, not more government regulation, controls, and subsidies. The Massachusetts reform takes us in the wrong direction.