Massachusetts Passes Universal Health Care Package
"An Act Providing Access to Affordable, Quality, Accountable Health Care"

Updated: March, 2007

The Massachusetts legislature presented the much-touted health care reform package to Governor Mitt Romney on April 12, 2006 for his signature. Now law, the "Act Providing Access to Affordable, Quality, Accountable Health Care," Chapter 58 of the Acts of 2006 [full text], reflects a series of compromises between Democrats and Republicans aimed at ensuring that all citizens have access to health care. Senate President Robert Travaligni told State Legislatures Magazine, "We started on a marathon course few have finished. There have been no easy solutions to the health care crisis, but I believe we have produced a blueprint of creative programs that serve as a template for other states." The law pulls together a number of strategies targeting various uninsured populations, including an individual mandate that all citizens have health insurance by July of 2007. It also creates the Commonwealth Health Insurance Connector, which assists small businesses and individuals in navigating the insurance world.

Commonwealth Connector

Mass. has yet to collect fees from firms for healthcare. Totals expected to fall far short of predictions
By Alice Dembner, Globe Staff
NOTE: NCSL provides links to other Web sites from time to time for information purposes only. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.

MA: Health plan may exempt 20% of the uninsured
By Alice Dembner, The Boston Globe (registration)
To remove the threat of a public backlash, the state plans to exempt nearly 20 percent of uninsured adults from the state's new requirement that everyone have health insurance. Read More
NOTE: NCSL provides links to other Web sites from time to time for information purposes only. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.

MA: Massachusetts offers details on health coverage
By Pam Belluck, The New York Times (registration)
BOSTON - Massachusetts is poised to become the first state to make it possible for 99 percent of its adults to be covered by health insurance, with an ambitious plan that sets limits for the premiums people would be expected to pay. Read More
NOTE: NCSL provides links to other Web sites from time to time for information purposes only. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.

Commonwealth CareFrequently Asked Questions

New item Governor Deval Patrick's six weeks on intense negotiations with health insurance plans CEOs results in lower prices more in-line with 2006 predictions.

MA: State gives more time for bids on insurance
By Alice Dembner, The Boston Globe (registration)
Faced with mounting questions about cost and coverage, a state agency yesterday again put the brakes on its fast-track schedule to define how much health insurance every Massachusetts resident must have.
Read More

Connector Authority Expands Access
Commonwealth Care Enrollment Contribution Tables
Hear from the Programs' Creators:
Presentations from the Annual Meeting session, Massachusetts Health Reform
Speaker of the House Salvatore F. DiMasi
Senator Richard T. Moore
Heritage Foundation's Center for Health Policy Studies Research Fellow Edmund F. Haislmaier

More information on MA:
Massachusetts released the affordability definitions in August; click here for more information: link
Legislature's act summary, PowerPoint presentation
Governor Romney's partial veto message, press release
Note: The Legislature overturned all but one (Section 112) of Gov. Romney's vetos

Will the Massachusetts Plan be Replicated in Other States?
The transferability of the Massachusetts legislation to other states is questionable, but many states are looking at similar components of the act. The political and demographic make-up of Massachusetts is unique, and the Health Care Access and Affordability Act builds largely upon existing resources within the health care system, which allowed legislators to fund most of the expansions. Components of the reform plan may be replicated, but transplanting the Massachusetts plan to another state with its own unique systems and needs could be difficult. At the time HB 4850 passed, eight states were considering plans to implement universal health care. Each of these proposals looks different, however; some states' plans include single-payer models, Canadian-like structures, or require partnerships between Medicaid programs and employers. The Massachusetts legislation included an employer mandate, which is structurally different but shares some goals with the Fair Share Health Care Fund Act passed in Maryland in January of 2006 (link). In Massachusetts, any employer with 11 or more employees that did not offer health insurance would pay their "fair share" of the cost of covering the uninsured, at a rate of $295 per employee per year. The Massachusetts act also includes components similar to legislation passed in states like New Jersey and Colorado to raise the age of dependency. Now, Massachusetts children will be eligible for coverage as dependents on their parent's plans until age 25, or two years after they become independent, whichever comes first. It also includes an expanded use of Health Savings Accounts in some circumstances.

NCSL's Health Program is tracking these trends in all 50 states. Please see our bill tracking pages for the most up-to-date information on these issues:
Universal Health Care
Pay or Play (Related to Employers)
Employer Disclosure/Reporting
Dependent Status
Health Savings Accounts
Disclosure of Health and Hospital Charges

Other States with Universal Health Care Plans:
The concept of universal access is not new to Americans, but Maine became the first state to pass such legislation in 2003 with the Dirigo Health Reform Act, a measure aimed at providing every citizen with access by 2009. In 2005, Illinois passed the All Kids Health Insurance Program, creating a system whereby all children under the age of 18, if not already covered by their parents or by another state-sponsored program, could access coverage. Hawaii, too, is often cited as an example of universal access; their plan, the "Prepaid Health Care Act" passed in 1974 with a unique ERISA exemption, requires all employers to offer health care coverage.

*See What the Nation's Top Newspapers are Saying:

After the Bill Became Law:
Boston Globe, April 13, 2006
L.A. Times, April 13, 2006

NCSL's State Health Notes Article
Kaiser Comission on Medicaid and the Uninsured's Brief: Link

*The NCSL Health Program regularly collects articles of interest to legislators, policymakers and those interested in health-related issues. We provide the link above for informational purposes only, and it does not necessarily reflect NCSL positions.

Please note that some links may not work since many media Web sites only keep active links to articles for a limited time, some as little as 24 hours. If you are interested in a story with a link that does not work, please visit the Web site of its origin.

Massachusetts Passes Universal Health Care Package"An Act Providing Access to Affordable, Quality, Accountable Health Care"

Massachusetts Passes Universal Health Care Package
"An Act Providing Access to Affordable, Quality, Accountable Health Care"