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Since the Supreme Court upheld the ACA/Obamacare, there has been a renewed interest in the Massachusetts healthcare law. I have blogged many times before to caution readers and the media not to assume the two laws will lead to the same results, because they won’t, mostly as Massachusetts is not the same patient with the same ailments as New Mexico, or Michigan, or even Florida.

I know I am fighting against the conventional wisdom,  but this issue warrants discussion as Congress passed a national program and modeled the behavior and cost estimates (incorrectly in my opinion) partially on our experience here in the Bay State.

As a result of the national interest, I assume we will see more local reports on Romneycare. On cue, WBUR’s CommonHealth Blog put up:

5 Quick Facts About Mass. Health Reform You Now Need To Know

One of the facts cited is the decrease in the number of Massachusetts residents paying the individual mandate penalty.

Seems encouraging, right? More people must be getting insurance. Perhaps, but a closer look at the data raises some interesting questions.

After discussing provisory exemptions with Pioneer’s Senior Fellow Amy Lischko, she dug up religious exemption data, and those persons exempt because insurance coverage is deemed “unaffordable.”

What did we find?

Individual exemptions skyrocketed recently with an increase of almost 50,000 from 2008-2010.

It appears more people are figuring out a way to get an exemption. The Connector has said they are being more forgiving because of the economy. But it may also be that some people are getting better at hiding income. Either way, it should kill the argument that over time more and more people are giving into the mandate, gaining insurance as a result.

The threshold to receive an exemption is in the hands of the Connector. The threshold for a Hardship Waiver outlines what conditions they will accept to grant a waiver. Regardless of you opinion of the conditions, it should make us nervous when a government agency is given power to unilaterally pick winners/losers and is also able to move the goal posts on their own. Such is the case we find ourselves in Massachusetts.

Josh Archambault is director of health care policy at the Pioneer Institute in Boston (, publisher of “The Great Experiment: The States, The Feds and Your Health Care.” This post appeared at The Pioneer Institute Blog.

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3 Responses for “Are Fewer People in MA Paying the Individual Mandate Penalty?”

  1. Very interesting, though speculative, information here. In regards to your last thought about the “government picking winners and losers and changing the goal posts” on health insurance, DO YOU REALLY WANT TO LEAVE THAT TO THE INSURANCE COMPANIES LIKE IT IS NOW!

  2. Peter1 says:

    “A 2011 poll by The Boston Globe and the Harvard School of Public Health similarly showed that 63 percent of Massachusetts residents supported the state law, and that support had risen since 2009.”

    Would that be 63% of those receiving tax free, union negotiated, employer paid health insurance?

  3. steve says:

    Josh- Why not just tell us if more people are getting insurance? If you dont know, several of us here can point you to the data. What was population growth during that period?


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