Health Affairs on Thursday published several Web exclusives that examine Massachusetts' new health insurance law, which requires all state residents to purchase health insurance by July 1, 2007, and requires employers in the state with 11 or more employees to provide coverage for workers or pay an annual fee of $295 per worker. The law also will establish a low-cost, state subsidized health insurance program for residents with annual incomes less than 300% of the federal poverty level and expand Medicaid coverage for state residents (Kaiser Daily Health Policy Report, 7/27). Summaries of the Web exclusives appear below.

"The Third Wave of Massachusetts Health Care Access Reform": John McDonough, executive director of Boston-based Health Care For All, and colleagues describe the background of the Massachusetts health care system and the major provisions of the Massachusetts law (McDonough et al., Health Affairs, 9/14).

"Massachusetts Health Care Reform: A Look at The Issues": John Holahan, director of the Health Policy Center at the Urban Institute, and Linda Blumberg, principal researcher at the center, examine the politics behind the legislation and the law's key details. The authors also discuss affordability, issues the state will have in implementing the law, whether employers will drop employee health insurance in response to the law, and whether financing will be adequate in both the short and long terms (Holahan, Health Affairs, 9/14).

"Massachusetts Reform Plus President Bush's Tax Credits: A National Model?": Lynn Etheredge, a consultant for the Health Insurance Reform Project at George Washington University, writes that the Massachusetts law could be a model for a federal-state strategy to provide coverage to the uninsured. Etheredge adds that President Bush's proposed health insurance tax credits could be added to the Massachusetts law and that a combined plan could include Medicaid expansions and offer workers affordable coverage through competition in the insurance market (Etheredge, Health Affairs, 9/14).

"Massachusetts Health Reform: Beauty Is in the Eye of the Beholder": Elizabeth McGlynn, associate director of RAND Health, and Jeffrey Wasserman, senior policy researcher at RAND, write that the Massachusetts law offers lessons related to health reform, including that bipartisan cooperation is possible and that multiple policy issues must be considered to implement such changes. The authors say that objective analysis and a comprehensive framework to evaluate policy options are necessary to implement similar reforms in other areas (McGlynn/Wasserman, Health Affairs, 9/14).

"Massachusetts: More Mirage Than Miracle": Tom Miller, resident fellow at American Enterprise Institute, writes that the complexities associated with enforcing a mandate that individuals purchase health insurance and with making changes to the existing high-cost health system will challenge successful implementation of the Massachusetts law. Miller suggests that Massachusetts policymakers consider policy options that address improving the health services already available to all residents rather than on the financing necessary to provide universal coverage (Miller, Health Affairs, 9/14).

"The Massachusetts Model: An Artful Balance": Nancy Turnbull, president of Blue Cross and Blue Shield of Massachusetts, writes that although the Massachusetts law is promising, there will be challenges in its implementation, including building support for the law and containing costs. Turnbull adds that the law's success will depend on how well the state responds and adjusts to implementation challenges (Turnbull, Health Affairs, 9/14).


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