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Bay State Rationing
Unable to pay the enormous cost of Commonwealth Care, the state's subsidized insurance plan for low-income residents, Massachusetts lawmakers are throwing legal immigrants off the rolls. The state simply does not have enough money to pay its bills, and cuts have to be made somewhere.

Three years ago, Massachusetts enacted a law that required every resident to have medical insurance. Commonwealth Care was created to subsidize those who couldn't afford to buy their own. It didn't take long for the program, which never achieved coverage for everyone, to run into trouble.

Costs soared from $158 million in the first year to $630 million in 2007, then doubled in 2009 to $1.3 billion. Enrollment in the program has also surged. It stands at roughly 181,000, up from 165,000 in the early spring, and is projected to reach 212,000 next year.

With 200,000 still uninsured — most of whom likely would be eligible for the subsidized program — imagine how much more steeply the costs would be rising if the state had met its goal of insuring everyone.

Both Democrats and Republicans hailed Massachusetts' attempt to ensure that everyone had medical insurance coverage. Some on the right even praised the state for taking a market-based approach to the issue.

A few observers, however, correctly noted that such a system cannot possibly be sustained. Demand, they said, will overwhelm it, just as demand has caused medical care rationing in Great Britain and Canada....