Sign Up for Email Alerts Visit us on Twitter Visit us on Facebook Visit us on YouTube Subscribe to RSS Feeds

Home > Past Briefings > Briefing Detail Page

Briefing Detail Page

Change Text Size:   Smaller Text Size   Larger Text Size   Default Text Size    

Massachusetts Health Reform: A Giant Step Toward Universal Coverage?

Friday, November 07, 2008

The upcoming presidential election and the domestic economic scene have captured the top-of-mind attention of both voters and the media. But not far below the top is a profound concern about health care. Will I lose my job and with it my health insurance? Can I afford the ever-increasing costs of rising premiums, higher deductibles and copays? Which candidate’s health plan will best alleviate my concerns?

Many states have taken a broad range of incremental steps to cover their uninsured citizens and address concerns about costs. Massachusetts has gone farther than the others, taking a giant step toward universal coverage. Last month, the Bush Administration announced an extension of the Massachusetts Medicaid waiver and associated federal financial support for its subsidized coverage plan.

The Massachusetts model, enacted in 2006, is being watched closely for lessons that might guide national efforts to reduce the number of uninsured and underinsured nationally. Of particular interest are the individual and employer mandates that are part of the package, and how the state is addressing access and affordability. The ranks of the uninsured in Massachusetts have dropped dramatically, yet questions remain.

Precisely, how is the pursuit of universal coverage progressing in Massachusetts? What impact, if any, are the reforms having on insurance costs? Are the newly insured able to actually get the care they need? Is subsidized coverage “crowding out” employer-sponsored coverage? How are employers responding to the reforms more generally? Can the state afford the subsidies as economic problems affect tax revenues?

To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund are sponsoring a November 7 luncheon briefing. Speakers are: Sharon Long, Urban Institute; Jon Gabel, National Opinion Research Center; and Jim Klocke, Greater Boston Chamber of Commerce. Ed Howard of the Alliance and Anne Gauthier of Commonwealth will co-moderate.


 Anne Gauthier, The Commonwealth Fund, Moderator
 Ed Howard, Alliance for Health Reform, Moderator
 Sharon Long, Urban Institute, Speaker
 Jon Gabel, National Opinion Research Center, Speaker
 Jim Klocke, Greater Boston Chamber of Commerce, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Massachusetts Health Reform: A Giant Step Toward Universal Coverage? (Adobe Acrobat PDF), 11/7/2008
Event Summary: Massachusetts Health Reform: A Giant Step Toward Universal Coverage? (Word Document), 11/7/2008
Full Webcast/Podcast: Massachusetts Health Reform: A Giant Step Toward Universal Coverage?

The transcript, full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Anne Gauthier Presentation (PowerPoint), 11/7/2008
Sharon Long Presentation (PowerPoint), 11/7/2008
Jon Gabel Presentation (PowerPoint), 11/7/2008
Jim Klocke Presentation (PowerPoint), 11/7/2008

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Survey Finds Employers Ambivalent About Health Overhaul Plans (Adobe Acrobat PDF), Congressional Quarterly HealthBeat, 10/22/2008
As Feds Eye Health Overhaul, States' Experiences May Prove Helpful (Adobe Acrobat PDF), Congressional Quarterly HealthBeat, 9/26/2008
Employers protesting upcoming health care assessment (Adobe Acrobat PDF), The Patriot Ledger, 8/13/2008
Sourcelist (Word Document), , 11/7/2008
Massachusetts Health Reform: A Giant Step Toward Universal Coverage? (Word Document), MS Word Document, 11/7/2008

Offsite Materials (briefing documents saved on other websites)

After The Mandates: Massachusetts Employers Continue To Support Health Reform As More Firms Off, Health Affairs, 10/28/2008
Court upholds San Francisco employer insurance mandate, American Medical Association, 10/27/2008
Employers Who Had Fifty or More Employees Using MassHealth, Commonwealth Care, or the Uncompens (Adobe Acrobat PDF),Massacusetts Executive Office of Health and Human Services Division of Health Care Finance and Policy, 5/15/2008
Financing for Massachusetts Preserves Health Plan , The New York Times, 10/1/2008
Health Care Reform in Massachusetts — Expanding Coverage, Escalating Costs, New England Journal of Medicine, 6/26/2008
Health Care Reform in Massachusetts: Medicaid Waiver Renewal Will Set a Precedent, The Heritage Foundation, 7/2/2008
Health Connector Facts and Figures, Massachusetts Health Connector, 10/1/2008
How Have Employers Responded To Health Reform In Massachusetts? Employees' Views At The End Of , Health Affairs, 10/28/2008
How Many Are Underinsured? Trends Among U.S. Adults, 2003 and 2007, The Commonwealth Fund, 6/10/2008
Is Massachusetts a Model at Last?, American Enterprise Institute, 1/3/2007
Letter to Speaker DiMasi and Senate President Murrary (Adobe Acrobat PDF),Massachusetts Taxpayers Foundation, 7/23/2008
Malpractice in Massachusetts: How Bay State Policy Undermines Health Reform, The Heritage Foundation, 9/15/2008
Massachusetts Health Reform: High Costs and Expanding Expectations May Weaken Employer Support, Center for Studying Health System Change, 10/30/2008
Mass. eases health assessment rules, Business Insurance, 10/6/2008
Massachusetts Health Care Reform: Two Years Later, The Kaiser Commission on Medicaid and the Uninsured, 5/19/2008
Massachusetts may delay penalties, Business Insurance, 9/22/2008
On the Road to Universal Coverage: Impacts of Reform in Massachusetts at One Year, The Commonwealth Fund, 6/3/2008
Poll Shows Strong Support for MA Health Reform Law, Harvard University School of Public Health, 7/15/2008
Report to the Massachusetts Legislature Implementation of the Health Care Reform Law, Massachusetts Health Insurance Connector Authority, 10/2/2008, The Boston Globe, 9/6/2008
Taking Massachusetts National: An Incremental Approach to Universal Health Insurance, The Brookings Institute, 7/1/2008
Testimony of Michael Widmer: Employer Fair Share Contribution Hearing, Massachusetts Taxpayers Foundation, 9/5/2008
Impact of Health Reform on Underinsurance in Massachusetts: Do the Insured Have Adequate Protec, The Urban Institute, 10/16/2008
Two safety-net hospitals hit hard by budget cuts, The Boston Globe, 10/17/2008
Universal Health Insurance Reform, University of Utah Center for Public Policy & Administration, 9/24/2008
Who Gained the Most Under Health Reform in Massachusetts?, The Urban Institute, 10/16/2008
States Moving Toward Comprehensive Health Care Reform, Kaiser Family Foundation, 11/5/2008


Anne Gauthier, assistant vice president of The Commonwealth Fund, was co-moderator of the Nov. 7 briefing co-sponsored by The Fund.

Sharon Long of the Urban Institute discusses how employers responded to health reform in Massachusetts. (10 min.) From the Nov. 7 briefing cosponsored by The Commonwealth Fund.

Jim Klocke, executive vice president of the Greater Boston Chamber of Commerce -- speaker at the Nov. 7 briefing cosponsored by The Commonwealth Fund.

Jon Gabel of the National Opinion Research Center explains that employers in Massachusetts still support reform efforts there, after experiencing them. (11 min.) From the Nov. 7 briefing cosponsored by The Commonwealth Fund.

Jim Klocke of the Greater Boston Chamber of Commerce discusses why Mass. health reform has lasted, and what lessons can be learned for national reform. (11 min.) From the Nov. 7 briefing cosponsored by The Commonwealth Fund.


Uwe Reinhardt Questions Bundled Payment Savings Prospects

Video (2:58)

A new Alliance for Health Reform video features Princeton’s Uwe Reinhardt questioning whether bundling payments for medical services might actually lead to higher – not lower – costs.

"The ACO's, the accountable care organizations, could create local monopolies that could dictate to you what that bundled price would be, and some of us fear that bundled prices might be even more than what the fee-for-service for that bundle would be today. … You really should align all the payers and say, 'Let us jointly negotiate with the ACOs what those bundles should be so that they cannot divide and rule and sort of make us on the buy side weak.'"


Read More 

Sister Carol Keehan on Health Law Enrollment Challenges this Year

Video 3:00

A new Alliance for Health Reform video features Sister Carol Keehan of the Catholic Health Association of the United States addressing the challenges of quickly enrolling millions of Americans for health insurance this fall. Open season begins October 1 of this year, yet she says that up to 85 percent of those who will be newly eligible for Medicaid or for subsidies to buy private insurance in state-based exchanges don't know it.  FULL TRANSCRIPT

Read More 

Jonathan Blum on CMS Efforts to Keep Medicare Spending Growth Down

Video (2:54)

Jonathan Blum, acting principal deputy administrator and director of the Center for Medicare at the Centers for Medicare and Medicaid Services (CMS), addresses the slower growth of Medicare spending over the last few years, and what his agency is doing to try and continue the trend. “There are promising signs that this strategy to change the payment system, to change the payment models, to focus on waste and abuse, is paying off," he said. "We are taking a whole new approach to addressing fraud in the program. Much more data resources, much more on the ground reaction. We have seen dramatic spending declines in areas of spending, such as home health and durable medical supplies that historically fueled lots of the fraud.”  FULL TRANSCRIPT

Read More 

Two Former Medicare Administrators Discuss How to Save the Program

A new Alliance for Health Reform video features two former Medicare administrators -- Gail Wilensky and Bruce Vladeck -- on their ideas about how to save the program.

Ms. Wilensky, who ran Medicare in a Republican administration, argued for increasing the eligibility age of Medicare for future retirees, while still making the program available at age 65 for those who are disabled.

Watch at

Read More 

Douglas Holtz-Eakin: Health Care Spending Lull Only Temporary

Video (3:11)

A new Alliance for Health Reform video features Douglas Holtz-Eakin of the American Action Forum, and a former director of the Congressional Budget Office, arguing that recent slower spending growth in health care won’t continue.

"We also saw a slowdown in the mid-90s, and we all declared victory and it came right back. I think next year we’ll see a noticeable uptick. There will be lots of new people entering the insurance markets because of the exchanges and the subsidies that come along with them, and those subsidies are very generous. … These are an invitation for people to get coverage and to buy more health care. I think that’ll place a lot of pressure on spending."


Read More 

Marketplace Enrollment Helpers Toolkit

Beginning October 1, insurance marketplaces open for enrollment, and millions of people will be eligible to purchase plans. To guide them in the application process, the federal government has invested in programs to train community organizations and hired staff.

Read More 

The Employer Mandate of the Patient Protection and Affordable Care Act

The Toolkit, available here, details the ACA’s employer requirements and penalty. It also includes information about the delay in the mandate to 2015, and analysis about its impact on employer-based coverage.

Read More 

Toolkit: Training the Workforce for a Changing Health System

A new Alliance for Health Reform toolkit addresses concerns about whether newly-trained physicians are adequately prepared for today's evolving health care delivery system. Does training adequately emphasize care coordination, team-based care, costs of care, health information technology, cultural competence and quality improvement? Does it encourage students to practice in a primary care setting?

Read More 

Toolkit: Emergency Preparedness in the U.S.: The Ebola Threat

Is the U.S. prepared for a potential virulent pandemic? This new Alliance toolkit examines public health infrastructure, funding and policy levers that deal with these kinds of health crises in America.

Read More 

Copyright 1997-2014 Alliance for Health Reform
1444 Eye Street, NW, Suite 910 Washington, DC 20005-6573      202-789-2300      202-789-2233 fax      Sitemap