Now that federal health care legislation of some sort seems pretty much a done deal, I guess it's time for those of us who support the idea of universal coverage to start freaking out about what the reality's going to look like.  Especially those of us in Massachusetts who have finally adjusted to the state health insurance plan. 

My current job does not offer health insurance, and friends of the blog know I have struggled with Massachusetts' health coverage reforms.  But after nearly three years with Commonwealth Care, I finally seem to have gotten the hang of it.  My health insurance premiums and co-pays are affordable for me (although premiums have tripled and co-pays doubled in the three years the program has been in place), and while I'm perfectly healthy, I'm finally getting preventative care — physicals and regular check-ups — I could not afford to pay out of pocket for when I was uninsured. 

So everything seems to be going to plan.

I have not read the various bills wending their way through Congress, of course, but if reports from sources at least somewhat sympathetic to health care reform can be believed, one very likely result of federal reforms (hysteria over the death of small businesses aside) may be scaled-back subsidies, which would mean higher premiums and co-pays for people who probably can't afford health insurance in the first place.  Like, um, me.

The good news is, the federal mandate is likely to be much weaker than in the current Massachusetts plan.  Which means, if in the end you don't qualify (because the government has raised the bar in order to shrink the ranks of those receiving subsidies), but your employer won't cover you, you can go back to being uninsured for a small fee, I guess.  

But when that's the good news, well, you know what they say about the road to hell.