North Reading Man Sues State Over Health Insurance Costs

NORTH READING (CBS) – It’s a catch 22: pay for health insurance or pay a hefty fine. A North Reading man has argued he can’t afford either, so he’s suing the state.

Michael Merlina is not a lawyer: he’s a glass guy. But, Merlina is suing the state, saying he can’t afford health insurance or the fine for not having it.

“They fined me $2,000 in 2009 because I was unable to provide health care for me and my wife,” said Merlina.

Merlina’s insurance disappeared with his wife’s job in 2009. His family’s small business doesn’t provide it.

WBZ-TV’s Peg Rusconi reports

Health care would cost them $425 per month through the state’s Health Insurance Connector. The connector’s attorney said based on Merlina’s $70,000 adjusted gross income, they can afford it.

“If you look at the regulations and how one could overcome the presumption of affordability, they talk about things like sudden homelessness, the shutoff of essential services,” said the attorney.

The judge noted Merlina’s expenses outweigh his income.

“There are things I could cut, but the problem is there aren’t enough things that I can cut to make up that $425,” said Merlina.

Neither side can claim victory yet. The hearing was quick, but the judge is taking some time to think about the case and promised a ruling soon.

The state’s attorney said the Connector’s affordability tables are adjusted every year. She said under the conditions written by the legislature, a person has to prove paying for health insurance would deprive them of basic needs such as food, clothing and shelter.

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  • Political Thread - Page 992 - Fires of Heaven Guild Message Board

    […] cost when it was implemented, and now is causing them to go completely broke, yet lots of people still can't afford the cost or the penalty. Is that the same thing we're talking about here? __________________ […]

  • David Richardson

    Here is a prime example for you…If you do not pay for insurance in Mass. you are fined and they will take the money from your state income taxes. None for me thanks.

  • Michelle

    My husband makes roughly 36k/yr and I stay home with our 6mo old daughter. We decided I should stay home because what little I make when working would go directly to daycare costs (and then some, for sure). The State of MA says we can afford $170/wk for a married/family plan through his company. After mortgage, car payment, gasoline, phone, insurance bills, etc., there ISN’T $170/wk left to pay for healthcare. We’re lucky if there’s 40 bucks left for food, formula and diapers! Meanwhile, I have a thyroid condition and asthma that go unmedicated because we can’t afford insurance or doctor bills. This state will take care of non-citizens, no questions asked – free healthcare, free food, free housing, etc.. Folks who have paid into the system since their teens, get no healthcare and a hefty fine come tax season. Shame on you, Massachusetts.

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  • Chen

    Healthcare reform as scujebt was difficult for President Obama because he had all the odds facing him of his historic win as the President through public’s vote that his inherent mettle won.AMERICA needed change and now he (Obama) says this is what change looks like – while he is right in saying that, his spirit is now in sealing healthcare that is internally based for America.Constitution of the land always reflects the sensitivities of its people where others, I mean outsiders have not to be and there, even I include myself as the outsider, “I am sure my friends of the blog promoting this as writers would appreciate that” – The point is, I had basically stood for the change in totally selfless terms and I have also a life of my own with my family that in my terminology is poorest from the poor in material terms today. This is my individual statement related in no way with the members of my family as relations who, I would say are also poorly placed materially despite their values standing as victim to circumstances entirely reflecting upon me yet alive with affection and love for me?I would not like to advocate myself materially on my healthcare and healthcare of my family for life because I am placed in a country that I can only say for myself has no material value for a person like me?? So, no grudges and that is why I am being made to disengage myself because Vishnu Power as Sri Gnash has taken me over “where life or death has no meaning to a Non Being as me”? –well, if that was my destiny of my Conscious Rebirth in life – no regrets because I want to be out of the manifestation for which I had stood till yesterday for life overall?The above question is not for me – it is for life to ponder over and for which as the last resort I had placed my material cards on Obama?“If Obama is an individual inherently from the rest as all, then, I am with him” all the way as “Vishnu”.Therefore, I do not know if it is my last comment on Michelle’s blog for Obama today?All I can say is, that “in my present material state as described above, it will be foolish on my part to continue any further and I am being frank to consume the own soup of my life in relating this” – sorry – despite this truthful submission, I still inherently stand for the good of all life?Through Absolute surrender under the GRACE,I remain,Yours faithfully for life,Ravinder Kumar.

  • Isa

    If they wanted to mbeoce a participating payor in the government plan they would have to agree to the payment formulary outlined by the government. For the companies that chose to go along with the government plan, you’d end up seeing a whole lot more HMO type plans available and the PPO plans would pretty much go away. Those that didn’t participate as payors under the government’s terms would pass their extra costs on to the consumer purchasing the insurance. If doctors are given an option to participate, they’ll refuse to accept the government plans and will jack up their costs to private pay insurance clients (the same as many are doing with Medicaid today). If it’s all nationalized and we fall under one payor, just take a look at how Medicaid works today and that’s what you’ll get. Doctors will also close up shop. Demand will be high and supply of qualified health care professionals will be low.Edit Another thing to consider is that there will be unanticipated levels of enrollment if they leave multiple payors in place and only have the government plan for those whose employers don’t offer coverage. Larger businesses will be required to offer insurance, but businesses with few employees won’t. Those small businesses that are offering it now will stop. Their employees will then mbeoce dependent on the government health care system. My mom’s a small business owner and pays part of her employee’s insurance costs now. I can assure you that if this kicks in she’ll drop it. She’s having a hard enough time keeping her doors open as it is and that would save her a ton. This is exactly what happened when Hawaii went to their plan to insure all children in the state. People dropped their private insurance and used the state insurance. The program lasted for about 6-7 months before the state couldn’t afford it any more.@ bob k If you think the greedy insurance companies are bad about determining what care you will and will not receive, wait until the government decides that for you. Ask any Medicaid patient about how much say they or their doctors have in the care that they receive, and you’ll love your greedy insurance company.

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