Romney’s goal, with the individual mandate, was to require people to buy catastrophic insurance that would cover emergency care. Romney’s version of the mandate was designed to compensate for the effects of the federal EMTALA law that requires hospitals to provide emergency care to everyone, regardless of their ability to pay…
However…when Deval Patrick assumed office, he populated the Health Connector board with progressives who favored mandating costly comprehensive insurance, instead of cheaper catastrophic coverage.
“The Romney administration had envisioned an unsubsidized exchange program that provided small employers with a healthy defined contribution model,” writes Archambault. “The model’s goals were to move the current employer-based system to an individual purchase decision and encourage competition and consumerism.”
But that’s not what the Patrick administration implemented. Instead, Massachusetts’ “Commonwealth Choice” plan forced insurers to offer standardized “Gold,” “Silver,” and “Bronze” plans that were required to offer generous, comprehensive coverage, including mental health, substance abuse, rehab services, and vision care. Small businesses could only offer their employees plans from one of the three tiers, further limiting consumer choices. (This framework is also part of the federal Affordable Care Act.)