Starting in 2014, when much of the federal Affordable Care Act takes effect, millions of other Americans could face a similar decision about whether to get healthcare coverage or pay a penalty, putting Massachusetts in the spotlight as a possible barometer of what the country could experience, The Boston Globe reported Friday.
The federal plan mimics the Massachusetts law in that it makes health insurance more affordable through subsidies and a state-run insurance market and compels most people to buy a plan or pay a penalty if they don't.
"Massachusetts is culturally more open to that kind of a bargain," Alan Weil, executive director of the National Academy for State Health Policy, told the Globe.
More of the uninsured in other states could decide to pay the penalty than have in Massachusetts, where the majority of residents had insurance before the state law passed.
People might be less persuaded to buy a plan in states where politicians and others have encouraged people not to comply, Weil said.
Republican leaders in Florida, South Carolina and elsewhere have indicated they would resist enacting or enforcing major provisions of the law, including expansion of Medicaid to make government-funded coverage available to an estimated 17 million low-income people nationwide, the Globe said.
"The concept of the mandate was never to force everyone [to buy insurance]," Weil said. "It was set in a whole system where everyone has an option and then you say, 'You know what, we need you to pick one.'"
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