Beyond Obamacare: Lessons from Massachusetts
A Brief History of Health Care Reform in Massachusetts

Barbara Anthony



Massachusetts is the first state in the nation to establish a legislative growth target to control healthcare costs. At present, the law - Chapter 224 of the Acts of 2012, An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation - is unique to Massachusetts, although a few states, such as Rhode Island and Connecticut, are taking a look at similar approaches to controlling healthcare costs.

This article traces the history of healthcare reform legislation in Massachusetts that became the model for the Affordable Care Care Act (Obamacare) and it examines a number of major issues raised by Ch. 224. (1) The culture developed by Massachusetts’ policymakers and healthcare stakeholders to pass Ch. 224; (2) A description of the implementation tools in Ch. 224; (3) The effectiveness of those tools and of the Health Policy Commission in controlling the growth of Massachusetts’ healthcare costs; and (4) Whether or not this approach is good public policy. An exciting feature of this Massachusetts experiment is that it is still evolving and adapting to changing market conditions; with time, new tools may be added to its cost control provisions. Its ultimate success or failure may not be readily apparent for years to come. 

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