When I first met Madelyn Rhenisch of Boston, I wondered, "How many more Madelyns are out there falling through the cracks of the health care system?"
For most of the last 10 years, the 56-year-old suffered from chronic fatigue syndrome and couldn't work, which meant no insurance coverage and mounting medical costs. Her monthly prescription bills alone cost her a staggering $500 to $600 a month, she told me. She burned through her retirement savings just to make ends meet.
"It was a shock," she said in an interview. "It's a totally different life if you have insurance than if you don't and I don't think anyone on insurance has any clue what it's like to suddenly not have any insurance."
Last fall, she was asked to become the first enrollee in the state's new mandatory health care system and jumped at the chance.
"I hope it's a step towards universal insurance and I hope the government will get more involved because it really needs the voice of me and all the other people that have, have situations that don't fall in boxes," she said.
Her state is now trying to become the first in the country to insure every resident. If Massachusetts leaders are feeling the pressure, they're trying not to show it. The man tasked with making the new plan work, Jon Kingsdale, told me in an interview, "Failure is not an option." Then he laughed and said the state's new governor, Deval Patrick, told him, "Don't muck it up."
That's because the stakes are high and not just for Massachusetts. We were told that some 20 states – including California – are studying the Massachusetts model.
"If it fails in some way, that will probably set back in some way the cause of states taking the initiative to expand coverage," Paul Ginsburg, president of the Center for Studying Health System Change , told me in an interview.
The state's already facing some big challenges: How do you convince people who don't make much and who haven't purchased health insurance in the past that they'll have to pay a monthly premium – a premium that could be as high as $106 for someone making under $30,000? And if you convince people they need to enroll, can they afford to sign up?
But if the plan works, it can change lives. That's what we saw when we met Madelyn Rhenisch.