President, Blue Cross Blue Shield of Massachusetts Foundation

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Nancy Turnbull

Massachusetts health care initiative to attain "near universal coverage" has a little something for everyone, Nancy Turnbull, president of the Blue Cross Blue Shield of Massachusetts Foundation, said.

The proposal, Turnbull explained, combines an individual mandate with employer responsibility and state-subsidized access to affordable coverage for small businesses and lower-income residents.

"This transcends ideology," she said. "This is about shared responsibility."

Under the Massachusetts program,

• all Massachusetts residents, as of July 1, 2007, must prove on their state tax return that they have health coverage (as long as "affordable" coverage is available) or they risk financial penalties;
• all companies with 11 or more employees must offer their workers access to pre-tax purchase of insurance and make a "fair and reasonable contribution" to that coverage, or they must pay a "fair share" assessment of as much as $295 per employee per year;
• a Commonwealth Care program offers state-subsidized coverage to individuals with incomes of up to 300 percent of the federal poverty level and businesses with 50 or fewer employees.

"We're excited," she said. "We think we've embarked on something significant."

Turnbull's PowerPoint presentation is available here.