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29 J. Legal Med. 11 (2008)
Massachusetts Health Reform: A Model of Shared Responsibility

handle is hein.journals/jlm29 and id is 21 raw text is: The Journal of Legal Medicine, 29:11-22 Copyright @ 2008 Taylor & Francis Group, LLC 0194-7648 print / 1521-057X online DOI: 10.1080/01947640701876424 MASSACHUSETTS HEALTH REFORM A MODEL OF SHARED RESPONSIBILITY Christie L. Hager, J.D., M.P.H.* INTRODUCTION As the 2008 Presidential campaign season progresses, health reform has be- come firmly placed on the agendas of candidates of both parties. As platforms of national health care access are developed and refined, state-based health re- form efforts, begun long before declarations of current candidacies, proliferate and move beyond enactment and toward full implementation. Massachusetts is one state with an established state-based solution to what is considered by many to be the federal problem of expanding access to health care for the uninsured and underinsured. As the federal government has debated and implemented proposals and policies aimed at constricting and shrinking the federal contribution to the Medicaid program, states have been confronted with a growing crisis in uninsurance, of varying degrees and in varying forms. Expanding access to health care is but one of the commonly accepted goals of health reform; however, access presented an achievable goal as the policy window opened for sweeping health reform in Massachusetts in late 2004. In 2006, in the face of an expiring Medicaid waiver, the Massachusetts legislature enacted An Act Providing Access to Affordable, Quality, Account- able Health Care.' Pursuant to subsequent federal approval, it succeeded in preserving and maximizing federal funds available to support care for the Commonwealth's lowest income uninsured, redirecting significant, existing investment in services for the uninsured and underinsured, and reaching be- yond mere expansion of access to health care to the goal of coverage for nearly all of the Commonwealth's residents over the next three years. * Chief Health Counsel to the Massachusetts Speaker of the House of Representatives, Salvatore F. DiMasi. Address comments to the author at christie.hager@state.ma.us. 'An Act Providing Access to Affordable, Quality, Accountable Health Care, Chapter 58 of the Acts of 2006; 2006 Mass. Legis. Serv. 65-124 (West), available at http://www.mass.gov/legis/laws/seslaw06/ s1060058.htm (last accessed Sept. 17, 2007). 11

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