To those in favor of major healthcare reform, Massachusetts’ Mandatory Health Insurance represents a model of healthcare equity and universal coverage. To those opposed, it serves as a prime example of governmental intrusion and unwelcome mandatory participation.

Whichever side of the healthcare reform bill issue you’re on, there are positives and negatives to take away from the Massachusetts experience that can help shape a national plan:


Universal Coverage – Healthcare coverage is truly universal, requiring all Massachusetts residents to be covered.

Portability – Allows for the portability of health insurance coverage between jobs.

Transparent Costs & Quality —  The law requires a consumer health website be set up to compare the cost and quality of healthcare services. The website assists consumers in making informed healthcare decisions.

Bipartisan Effort – Massachusetts legislators put politics aside for the common good.


Mandatory – Companies with 11 employees or more must provide coverage for their employees. If they do not, the state of Massachusetts charges employers $295 per month, per employee for mandated health coverage.

Pay For Performance – Medicare reimbursement is tied to quality and performance.  Some say this approach harms the patient-doctor relationship by aligning the physician’s incentives more with reimbursement than care.

More Regulations – The system is complicated and requires additional levels of regulation and government involvement.

Enforcement – Massachusetts residents must provide proof of health insurance coverage on their tax forms or be penalized.

Early results show a decrease by more than 50% of adults without health insurance coverage, residents are paying less in out-of-pocket health expenses and low-income adults are now more likely to undergo regular check-ups and visit dentists.

The pros and cons of the Massachusetts healthcare model can be debated. But perhaps the most valuable lesson set by this progressive state is that significant national healthcare reform can be achieved if legislators are willing to work on a bipartisan basis.

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