After the first year of Massachusetts'RomneyCare health reform, the public is seeing the effectiveness of the plan that has an individual and employer mandate combined with a Medicaid expansion and new subsidized private health insurance plans, reports Boston.com. The results are interesting and point to the challenge facing anyone who wants to use government to require universal health care, even in a relatively high-income, low-uninsured state like Massachusetts. Key findings include:

• Overall uninsured rate dropped from 13% to 7%
• 355,000 newly insured
• 92,000 did not sign up for health insurance and face a $219 tax penalty that rises to over $900 in 2008
• 60,000 were exempt from the health insurance mandate for their low incomes
• The plan cost Bay State taxpayers $869 million this year, $150 million or 21%over the original budget

Massachusetts is suffering from Maine Dirigo Health's high cost overruns, but at least some of the uninsured are being covered.

Again, this is a preview of how expensive and difficult the easily-promised universal coverage really is.