Boston, MA, December 13, 2007.  Community Catalyst, a national consumer health advocacy organization, has released an analysis of the first year-and-a-half of Massachusetts’ comprehensive health reform package.  The report finds early success in the program due to robust enrollment, largely in subsidized programs for people with the lowest incomes.  However, the study also stresses that certain uncertainties and challenges remain in future implementation phases for the law, particularly regarding the individual mandate and long-term financing of reform. 

“Massachusetts has made great strides in the last 18 months to cover low-income, uninsured individuals,” said Michael Miller, Policy Director at Community Catalyst.  “A laudable consumer voice and significant outreach and public education efforts have helped lay the groundwork, but in order to sustain this effort and close the gap of uninsurance and underinsurance, difficult decisions will need to be made to secure funding in coming years and to guarantee that a healthcare option is truly affordable for every person in the state.”

Since health care reform passed in April 2006, hundreds of thousands of individuals have been covered in Massachusetts.  In fact, the most recent press reports indicate that enrollment is approaching 300,000.  While it is still too soon to know the results of every aspect of reform, the Community Catalyst report outlines several promising policies that have emerged, including:

  • Fully subsidized, comprehensive coverage for the lowest income adults;
  • Expanded Medicaid coverage for children; and 
  • Determination of the “floor” of insurance coverage for all residents of the Commonwealth.

Other features of the health reform law have not yet proven successful; time will tell their impact.  A low threshold for employers to either provide insurance or pay an assessment for uninsured workers is not likely to produce adequate revenue, and Massachusetts may face future financial distress without adequate funding from both the state and federal government for health reform.  In addition, it is too early to tell the repercussions of the impending individual mandate, especially whether penalties and the exemption process will prove fair and reasonable.

“Implementation of Massachusetts health reform has faced a number of challenges in its first year and a half, and it’s clear that there will be many more uncertainties to address as we move ahead,” said Brian Rosman, Research Director for Health Care for All, Massachusetts’ consumer health advocacy organization.  “Advocates have worked with the political leaders and stakeholders across the state to ensure that consumer voices have been part of the critical decisions to date and we’ll continue to participate in the implementation efforts make sure that health care coverage and access is a reality for all residents of the Commonwealth.”

In addition to findings on health reform policies, Community Catalyst’s report emphasizes the importance of consumer advocacy in making the law work.  In each major decision faced in implementation so far, advocates led by the ACT!! (Affordable Care Today) Coalition and Health Care for All have played a critical role.  The study cites this lesson for state advocacy groups: campaigns do not end with enactment; implementation is just as important. 

View the complete report Revisiting Massachusetts Health Reform: 18 Months Later.

About Community Catalyst
Community Catalyst is a national non-profit advocacy organization dedicated to quality affordable health care for all.  Since 1997, Community Catalyst has been working to build the consumer and community leadership required to transform the American health system.  With the belief that this transformation will happen when consumers are fully engaged and have an organized voice, Community Catalyst works in partnership with national, state and local consumer organizations, policymakers, and foundations, providing leadership and support to change the health care system so it serves everyone—especially vulnerable members of society.  For more information, visit