March 5, 2008 - Massachusetts has begun imposing stiff fines on residents who, for whatever reason, fail to purchase health insurance.

The program is the enforcement end of the state's universal health-insurance plan - and the fees reach up to $912 a year.

The state health-insurance initiative, signed into law by former Gov. Mitt Romney, has been compared to Democratic presidential candidate Hillary Clinton's national universal health-care plan - especially on the enforcement side.

The penalties apply to anyone deemed able to afford health insurance by the Commonwealth Health Insurance Connector Authority, the state agency that oversees the entire program.

Fines accrue every month to individuals not insured and are due as part of the tax-filing process for the year. The assessments began this year for the first time.

"The hefty fines are an indication of the failure of the program to provide the affordable health insurance that was promised," Arnold King of the Cato Institute told Health Care News.

The highest penalty for lacking insurance last year was the loss of the personal exemption, worth $219, on the individual's state tax return. This year the fine increased to half the total cost of the cheapest health insurance plan available through the state health insurance agency.

Through the plan, the state makes subsidized insurance available to individuals earning up to $30,636 per year and to families of four earning up to $61,956.

"The Massachusetts universal coverage plan is overregulated and largely unworkable," said Devon Herrick,, senior fellow at the National Center for Policy Analysis. "The least expensive plan would cost a 37-year-old male resident of Massachusetts $196 a month, and a fine for not having insurance could run half of that, or $98 a month. The same 37-year-old living in Dallas could buy coverage for $98 per month."