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ObamaCare in Massachusetts: What Happened

Back in 2006, Massachusetts was lauded for the efficient and advanced healthcare system that it had introduced under the leadership of then governor, Mitt Romney. The healthcare drive in the state enabled in bringing down the percentage of people without health insurance in Massachusetts to a mere 4 percent. That was then. The same state of Massachusetts today has failed to implement ObamaCare as planned. In fact, it failed terribly. Here is what went wrong.


Poor management

According to Don Berwick, a gubernatorial candidate for Massachusetts, ObamaCare failure in the state was mostly a management failure. Mr. Berwick, who was taking care of healthcare implementation earlier under the Obama administration, said that the state had not put in the best IT support as it should have, for implementing the Affordable Care Act. That has perhaps been an expensive decision for the state government, given that it had decided to scrap the exchange that it had built for implementing the ACA, by spending $175 million of the taxpayer’s money.


Implementing ObamaCare is not the same as implementing “RomneyCare”

Policy-wise, both ObamaCare and the healthcare reforms implemented under the Romney administration are alike. Technologically, these two healthcare acts are nothing similar. Assuming that they would be able to implement ObamaCare as they did the “RomneyCare” was perhaps another big mistake that the state made.


How ObamaCare differs from Massachusetts’ pioneering healthcare act

Both the policies are alike in the sense that they are based on one premise – to make healthcare affordable for all by extending private insurance. There are three policies that these two acts have in common

  • To make the individual insurance market an open market and ensure that insurers do not turn away those with an expensive health problem
  • Making insurance mandatory for all
  • To offer financial assistance to low-income and middle class Americans by offering subsidies.

The two acts, however differed in implementation of the policies. Massachusetts state set up a basic website that allowed individuals to compare and shop for policies that they found best. The ones eligible for subsidies had to apply for it manually, by filling a form. For ObamaCare, manual processing of applications for subsidies does not help, as the federal regulations require that those shopping for insurance under the ACA should be able to know in real time if they are eligible for subsidies, and be able to purchase the subsidized plan online.


Massachusetts, one of the “early innovators”

Massachusetts managed to get the “early innovator” grant along with six other states that had implemented the act earlier than the rest. In Massachusetts, there were multiple sites and multiple administration points that were poorly set up, as Massachusetts attempted to build a complicated system for the ACA implementation. In the words of Jon Gruber, who is a member on the board of the Health Connector, Massachusetts was over ambitious – the state “shot for the moon and missed”.