Massachusetts made history when it passed a law requiring residents to purchase health insurance or face fines beginning in July 2007. The bipartisan plan has been hailed as an innovative way to achieve universal health insurance coverage. It places responsibility on the individual to purchase health insurance under threat of fine, asks employers to subsidize insurance or pay a fee, and puts the government in charge of brokering plans that it promises will be affordable. Former Health and Human Services Secretary Tommy Thompson predicts that at least 20 states will soon follow Massachusetts’ lead and pass health care legislation with individual mandates.

A close examination of the program calls into question the premises underlying its passage and its ability to deliver on its promise of near universal coverage at affordable cost.

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