By Patrick McGroarty
Reporter Staff

Governor Mitt Romney was expected to sign into law a groundbreaking bill expanding access to health care for Massachusetts' residents at Faneuil Hall on Wednesday morning, as the Reporter went to press.

The radical legislation is a compromise based on bills put forward by the House, Senate, and Governor, and comes after more than a year of lobbying by health care providers and health care advocates to extend health coverage to all Massachusetts residents. Any changes to current law will go into effect in July of 2007, and the influence of new regulations will be felt across the neighborhood by hospitals, health centers, small businesses, and individuals. The heads of local health centers and progressive advocacy groups argued vocally to extend health care to cover more Massachusetts residents and they remain cautiously optimistic this week about the precise impact of this legislation.

"There were many other elements we were looking for, and we didn't get as much as we wanted," said John McDonough of Health Care for All. "But it's going to help a lot of people in Dorchester, who are not eligible for insurance, get it if they don't have it."

The enactment of this legislation is certain to mean big changes for Dorchester's health centers as well. Much of the bill's influence, said Michelle Nado, policy director for Dorchester House and Codman Square Health Center, will only become evident as centers start to function under the new regulations.

"We have a lot of patients who are working not one, but two jobs, who couldn't afford to purchase health care even if their employers offered it to them," said Nado. She also voiced concern for the medical needs of Dorchester's large population of undocumented immigrants. Such residents would only be covered in emergency situations under the new plan, but Dorchester House and Codman Square have policies that extends care to anyone who seeks it.

"Where are those undocumented immigrants going to go?" she asked. "Are they going to be helped by the free care pool, if that's still left?"

Her questions seemed all the more timely after the Boston Globe reported on Tuesday that beginning July 1 of this year, anyone seeking Medicaid coverage will have to show proof of citizenship to receive care. It is uncertain what that provision will mean in combination with new legislation, but local health officials had already voiced concern over the added burden of having to verify the citizenship of their patients, and the possible monetary burden of providing care to the few people who would fall outside the vastly expanded umbrella of health coverage.

"We don't really know what kind of requirements there will be to make sure our patients get enrolled in the plan," said Bill Walczak, CEO of the Codman Square Health Center. "It's an administrative burden. We become the ones mainly responsible for getting people in the community insured."

One provision of the legislation allows Romney the opportunity to veto any portion of the 145-page bill that he opposes. Romney had insinuated that he viewed most of the bill as a step forward, but in an April 11 editorial that appeared in the Wall Street Journal Romney indicated that he would veto a provision that would assess a $295 fee per employee to employers in businesses with 10 employees or more who do not provide their workers with health insurance.

"The fee is unnecessary and probably counterproductive," Romney wrote.

That was frustrating news to Carlos Vargas, founder and co-owner of Vargas and Vargas insurance. Vargas said that providing Blue Cross Blue Shield insurance to his staff of 15 eats up 14 percent of his annual operating costs, but that he has never considered cutting benefits from his employees.

"To hear the Governor say he's not going to sign that portion is a kick in the teeth," he said. "We're all paying a tax to provide free care to people who's employers are too irresponsible to provide them with coverage, and that's upsetting."

The Greater Boston Interfaith Organization (GBIO), a group of religious and lay people from across the city's neighborhoods and spiritual spectrum, said the bill is in most regards a positive one.

"We're concerned about long term sustainability of this plan, and about the affordability guidelines for individuals," said Sr. Sally McLaughlin. GBIO, she added, is also committed to ensuring parity between workers in need of insurance and their employers. But after a long fight to extend the availability of health care in Massachusetts, McLaughlin and others are optimistic about what has been hailed nationally as a breakthrough in health care distribution.

"It looks like a good bill," said Walczack. "But often with legislation, it really does come down to how important the details become, and what exactly they mean to us."