Mandated healthcare becomes a real possibility

Did we sell Massachusetts back to the British? Or give it as a welcome present to Prince Charles and Consort Camella? Maybe it was spun off into its own nation, so the Red Sox could finally dominate a league.

There has to be some Ripley’s reason for the silence that prevails as restaurateurs there contend with the industry equivalent of having a guy in a hockey mask ring your doorbell with the blade of a meat cleaver. Between now and next Tuesday, the state legislature will likely enact some major measure to expand healthcare coverage. Actually, two bills have already been passed by either the House or Senate, including one that would levy a 5% to 7% payroll tax on all employers who don’t provide health insurance to employees. The other will require that a new $105 million healthcare outlay be split in a different way. The immediate query might be which one will prevail. But the real question is, Are we seeing the start of mandated healthcare?

First, the basic facts: Yesterday. Massachusetts’ Senate unanimously approved a bill that would extend the state’s Medicaid program to about half the 500,000 Bay Staters who currently don’t have insurance. The measure was much milder than the industry might have feared. A leading alternative called for billing companies for healthcare expenses incurred by the employees they hadn’t provided with coverage. As a colleague noted, the charge just for Wal-Mart employees, and just in California, is reportedly $30 million annually.

The passage of the Senate bill follows last week’s lopsided approval in the House of the payroll-tax initiative, which would affect any business with more than 10 employees. Now the two measures have to be reconciled. That sometimes fractious process may be particularly pressured this time around because Gov. Mitt Romney has let it be known that he wants a reform bill on his desk before the legislature recesses. Romney is widely expected to be a candidate for the U.S. presidency in 2008, and a healthcare repair measure could snag him national attention.

The governor himself leans toward something more sweeping than what the Senate has OK’d.

The Massachusetts Restaurant Association is of course fighting the payroll tax idea. It had not released any formal comment on the Senate measure as of this writing.