Massachusetts Poised to Require Health Insurance

BOSTON —  Lawmakers overwhelmingly approved a bill Tuesday that would make Massachusetts the first state to require that all its citizens have some form of health insurance.

The plan would extend coverage to the state’s estimated 500,000 uninsured over three years. Poor people will be offered free or heavily subsidized coverage; those who can afford insurance but refuse to get it will face increasing tax penalties until they obtain coverage; and those already insured will see a modest drop in their premiums.

The cost was put at $316 million in the first year and more than $1 billion by the third year, with much coming from federal reimbursements and existing state spending, officials said.

A final procedural vote is needed before the bill can head to Gov. Mitt Romney.