What Massachusetts’ health care law did 20 years ago—and what’s left to do
By
Karen Feldscher
At the signing of Chapter 58, Massachusetts’ landmark health care law, in 2006: Gov. Mitt Romney shakes hands with Lt. Gov. Tim Murphy. Also pictured: U.S. Sen. Ted Kennedy (center) and Speaker of the Massachusetts House of Representatives Sal DiMasi (right). Photo: Elise Amendola / AP
In 2006, Massachusetts enacted a landmark health care law that made comprehensive changes to the state’s health system, including greatly expanding insurance coverage, and laid the groundwork for the federal Affordable Care Act (ACA). Two experts from Harvard T.H. Chan School of Public Health—John McDonough and Jeffrey Sanchez—recently spoke out about the importance of the Massachusetts law, as well as what’s still needed to make health care more affordable and accessible.
McDonough, professor of the practice of public health, served as executive director of the Massachusetts advocacy group Health Care for All from 2003 to 2008, and worked on Sen. Ted Kennedy’s staff during the writing and passage of the ACA.
McDonough wrote an article about the Massachusetts law—”An Act Providing Affordable, Quality, Accountable Health Care,” also known as Chapter 58—in an April 8 piece in CommonWealth Beacon. “Like it or hate it, Chapter 58 mattered,” he wrote. “The law followed through on its essential premise and promise to reduce uninsurance in Massachusetts to the lowest level anywhere in the nation. It also legitimized a bipartisan, implementable, and replicable model for what became Title I of the Affordable Care Act, resulting in the nation’s lowest uninsurance rate ever.”
McDonough also spoke about the law in an April 10 segment on WBUR. He noted that, while the law was crucial in expanding health care coverage, there is still much work to be done, such as reining in high health insurance premiums, deductibles, and co-pays, and easing difficulties related to prior approvals for medications and procedures.
Sanchez, a department associate in the Department of Health Policy and Management and a former Massachusetts state representative, also wrote about Chapter 58 in the Commonwealth Beacon. “The law solved an enormous part of the coverage challenge, but it did not solve everything,” he wrote. “Having an insurance card does not always mean being able to find a primary care doctor, afford out-of-pocket costs, access behavioral health services, or move easily through a system that remains too complicated and too uneven.”
The task ahead, he continued, is “to make care not only covered, but affordable; not only available, but accessible; and not only technically equal, but genuinely equitable.”
