Health Care Reform in Massachusetts: Impacts on Public Health

In 2006, with healthcare costs and the number of uninsured rising, Massachusetts passed landmark legislation that aimed to provide health insurance to everyone in the state. A product of bipartisan collaboration between a legislature dominated by Democrats and a Republican governor, the law contained several major innovations, including: mandates requiring residents to purchase health insurance and businesses to contribute toward employees' health care costs; programs to offer subsidized health insurance plans to low-income residents and to help wealthier individuals and small businesses buy coverage from private providers; and an expansion of the state's Medicaid program to cover more children in low-income families. This case explores some of the initial successes of the law's implementation, but also describes a number of challenges associated with it- not least of which was that within a year of the law's passage, Massachusetts, along with the rest of the nation, would endure a severe and protracted recession. Worsening economic conditions not only led to worries about the cost of expanding healthcare coverage, but also had serious implications for wellness initiatives and public health programs, which faced dramatic budget cuts. Exploring both the policy innovations of the law and the negative consequences of a poor economy, the case raises a number of points about the potential benefits of near-universal healthcare - while highlighting some officials' concerns that an overemphasis on expanding coverage could detract from other investments in public health programming. Case number 1995.0

• Innovation
• Healthcare benefits
• Business and government relations
• Public health services
• Healthcare and treatment