As backers of Obama’s health care plan look to Massachusetts model, state residents look away

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Mass. health model, not Obama’s, pleases voters

BOSTON — When Mary Foote cast her ballot in this week’s special Senate election, she was thinking about how the national health care bill strayed too far from the Massachusetts model and would force her to shoulder the financial burden of expanding health care in the other 49 states.

“I think we’re paying enough for the health issue in Massachusetts without paying for the rest of the nation,” said the 50-year-old cafeteria manager from Fitchburg, Mass.

In staging his upset win for the seat that “liberal lion” Edward M. Kennedy held for nearly 50 years, Republican Scott Brown tapped into those fears. He vowed to block President Barack Obama’s health care overhaul even as he defended the 2006 state law, which he supports and which continues to have the backing of a majority of Massachusetts voters.

The state law requires everyone who can afford it to be insured or face annual tax penalties. It also requires all businesses with 11 or more workers offer insurance or face annual penalties, and provides subsidized insurance to those earning up to three times the federal poverty level.

Brown argued that allowing the federal government to expand on the state law would result in higher taxes and deep cuts to Medicaid.

“Right now people are disgusted at the health care bill and how it’s going,” Brown said in the closing days of the campaign. “Everybody deserves health care coverage, but we can do it better; we have done it better here in Massachusetts.”

It was a message that resonated with voters like Ann Feeney. The Boston insurance agent said that health care, along with unemployment, were the main reasons she voted for Brown over Democrat Martha Coakley.

Feeney said that while she supports the Massachusetts law and thinks everyone should have health coverage, she didn’t approve of the way the national legislation was being shaped.

“I think it needs to be tweaked,” Feeney said. “I agree that everyone needs health insurance, but I don’t agree with the way they are doing it.”

Feeney wasn’t alone. A poll conducted this week by The Washington Post of 880 Massachusetts residents who said they voted in the special election found that 68 percent support the Massachusetts plan. Even among Brown voters, slightly more than half backed the 2006 law.

But support plummeted when voters were asked about health care proposals from Obama and Democrats in Congress.

Just 43 percent of Massachusetts voters said they supported them. Among Brown voters opposition soared to about 80 percent in the poll, which was released Friday and had a margin of sampling error of plus or minus 4 percentage points.

Voters who supported Brown said they also agreed with him that the process of crafting the bill had become politically tainted.

“They’re not willing to take the time to do it right. They’re just going to try to stick it down everyone’s throat, and people are angry about it,” said June Tomaiolo, a Shrewsbury resident who works in real estate and attended a rally for Brown just days before the election.

Brown said he didn’t just want to kill the bill, but wanted to send it “back to the drawing board” and open up the process.

“That’s the No. 1 thing people are telling me: They want everyone to have health insurance as I do, but they are just disgusted with the back-room deals,” he said.

Brown has said it should be up to states to decide, like Massachusetts, whether to expand health care with help from the federal government, if needed. He also largely avoided talking about key elements that the Senate bill shares with the Massachusetts law, including the requirement that nearly everyone be insured or penalties for businesses that don’t offer coverage.

Advocates of Obama’s plan say Brown is trying to have it both ways, defending his decision to support the Massachusetts law while opposing the Senate version. They say that the Massachusetts law was a blueprint for the Democratic bills and that in some ways the Senate version is more conservative because it includes tighter cost controls.

Rather than hurt the state, the Senate bill would expand Medicaid funding to Massachusetts and provide more funding for health research, said Brian Roman, research director for the advocacy group Health Care for All.

“I would want to know what he would want to go back to the drawing board to do?” Roman said. “It’s unfortunate that the Republican decision to say no, no, no, has really pushed Brown into a box that forces him to hold two positions with a lot of inconsistencies.”

Support for the state law isn’t universal in Massachusetts. It has done little to stem soaring insurance premiums even as it has expanded the number of insured residents to the highest in the nation — about 98 percent. And some residents have chafed under the penalties of noncompliance.

Jerry Cuellar, an unemployed retailer from Middleborough, said he agreed with Brown’s warnings about allowing Congress to pass too sweeping a bill after Massachusetts already had its own law.

“I don’t think Washington should have any part of telling me, my family or my doctor what they can to do with my health care,” said Cuellar, 49. “I just don’t trust Washington, Democrats or Republicans, to run the health care system.”

Associated Press writer Bob Salsberg in Boston contributed to this report.