BOSTON — Wayde Lodor is part of the 2 percent: the roughly 120,000 residents of Massachusetts who lack health insurance despite the state’s landmark 2006 law requiring almost every adult in the state to have it. He is likely to face a penalty this year, having made enough money under the state’s guidelines to afford a health plan. But Mr. Lodor, an independent product development consultant from Leominster, remains defiant.
“I’m in good shape, I don’t eat meat, I don’t drink excessively, I’ve never smoked,” said Mr. Lodor, 53, who estimates he would have to spend at least $1,200 a month to cover himself and his college-age daughter. “The last thing I’m going to do is not pay my rent because I have to pay for some state-mandated health coverage that I don’t think I need.”
As the Supreme Court hears arguments this week on the constitutionality of the national health care law and its requirement that most Americans be insured or pay a penalty, Massachusetts offers a real-world laboratory of how such a mandate might work.
Roughly 48,000 people in the state were subject to penalties for not having coverage in 2009, the latest year for which figures are available, down from 67,000 in 2007. The maximum penalties range from $228 to $1,212 a year, depending largely on income. (Anyone with an annual income of less than 150% of the federal poverty line pays no penalty.) The penalties are paid on state tax returns.
Massachusetts health officials say the shrinking number of violators is a sign that the law is succeeding. “I think the individual mandate in Massachusetts has been accepted by our population, understood, and broadly judged as fair,” said Glen Shor, executive director of the Massachusetts Health Connector, the state agency that helps residents find insurance coverage.
But for the relatively small universe of people who resist buying coverage, the mandate is a bitter pill. Teofilo Cuevas, 51, who earns about $40,000 a year as a meat cutter at a grocery store, said he had decided to drop his employer-provided coverage because even with insurance, he could not afford his out-of-pocket costs. He said he avoided going to the doctor.
“A lot of people cannot pay this,” Mr. Cuevas, an immigrant from the Dominican Republic, said through an interpreter.
For individuals facing penalties, who are often young, male and healthy, the state appears to have been generous in granting one-year waivers. From 2007 through 2010, the state approved 65 percent of the appeals filed by people who had been given penalties, or 7,163 out of 10,992, according to the Health Connector. State officials said appeals were granted based on proof of financial hardship, which might involve unemployment, a foreclosure or period of homelessness, or having to make the choice between paying for insurance or for heat and electricity.