The Massachusetts Law and its History

Complete text of the Massachusetts heath reform law, with links to relevant agencies, reports and regulations; summaries of its major provisions; and background on research and policy initiatives that led to its enactment.

What's in the law?

Interactive guide to the Massachusetts health reform law
Full text of Chapter 58 of the Acts of 2006, as subsequently amended and revised, with links to relevant agencies, reports, and regulations.

Massachusetts Health Care Reform Bill Summary
Early overview of the key provisions of Chapter 58 of the Acts of 2006, prepared by the BCBS of Massachusetts Foundation. (July 2006)

Health Coverage Strategies in Massachusetts
Summary of Massachusetts health reform's federal and state components and strategies, located on the Robert Wood Johnson Foundation's State Coverage Initiatives website.

Chapter 58: The Basics of Massachusetts Health Reform
Presentation on the history and key components of the 2006 law by John E. McDonough, former executive director of Health Care For All, to the Alliance for Health Reform. (May 2008)

Regulations governing implementation of Massachusetts health reform

Massachusetts Health Connector regulations
Regulations promulgated by the Massachusetts Health Connector that are related to the implementation of Massachusetts health reform.

• Medicaid Managed Care Organization Participation in Commonwealth Care
• Eligibility and Hearing Process for Commonwealth Care
• Employer Sponsored Health Insurance Access
• Minimum Creditable Coverage
• Determining Affordability for the Individual Mandate
• Administrative Bulletins

Massachusetts Division of Insurance regulations
Regulations promulgated by the Massachusetts Division of Insurance that are related to the implementation of Massachusetts health reform.

• Requirements for Disclosure of Minimum Creditable Coverage (June 2010)
• Requirements for Disclosure of Minimum Creditable Coverage (January 2008)
• Young Adult Health Benefit Plans
• Amendments Created by Chapter 205 of the Acts of 2007 Related to Eligibility as a Dependent in an Insured Health Plan
• Amendments Created by Chapter 58 of the Acts of 2006, as amended, Related to Eligibility as a Dependent in an Insured Health Plan
• Non-discriminatory Offer and Equal Contribution by Employers of Insured Group Health Benefit Plan Contracts Pursuant to Chapter 58 of the Acts of 2006, as amended

Massachusetts Department of Revenue regulations
Regulations promulgated by the Massachusetts Department of Revenue that are related to the implementation of Massachusetts health reform.

• Health Insurance Individual Mandate; Personal Income Tax Return Requirements
• Regulation Fact Sheet: Health Insurance Individual Mandate; Personal Income Tax Return Requirements
• Individual Mandate Penalties for Tax Year 2011
• Individual Mandate Penalties for Tax Year 2010
• Individual Mandate Penalties for Tax Year 2009 (Updated)
• Individual Mandate Penalties for Tax Year 2008
• Personal Income Tax Treatment of Employer-Provided Health Insurance Coverage for an Employee's Child

Massachusetts Division of Health Care Finance and Policy regulations
Regulations promulgated by the Massachusetts Division of Health Care Finance and Policy that are related to the implementation of Massachusetts health reform.

• Determination of the Employer Fair Share Contribution
• Employer Surcharge for State-Funded Health Costs
• Health Insurance Responsibility Disclosure
• Health Safety Net Eligible Services
• Health Safety Net Payments and Funding

Research and actions leading to enactment

Roadmap to Coverage Reports, 2002 - 2007 
Series of BCBS of Massachusetts Foundation reports that helped build and sustain the movement toward health reform by providing objective research on options for covering the uninsured in Massachusetts.

Forging Consensus: The Path to Health Reform in Massachusetts
BCBS of Massachusetts Foundation report by Irene M. Wielawski on how various interests in Massachusetts health care and politics overcame their differences and agreed to support reform based on “shared responsibility.” (July 2007)

Massachusetts Community Leaders Discuss the Enactment of Health Reform
BCBS of Massachusetts Foundation 2006 annual report, including the perspectives of leaders from politics, consumer advocacy, business, health care delivery, and academia on how the Massachusetts health reform law came about, and lessons learned in the process. (July 2007)

Philanthropy and Health Reform, 1982-2008
Community Catalyst report on the role that foundations and other philanthropic organizations played during more than two decades of health care reform efforts in Massachusetts. (January 2009)

Early Assessments of health reform

Massachusetts Health Reform: What it Does; How it Was Done; Challenges Ahead
Community Catalyst analysis of Massachusetts health reform, issued immediately after the Massachusetts legislature enacted the law. (April 2006)

A Blueprint for the Future: Massachusetts Health Care Reform
Transcript of an in-depth presentation on the newly enacted law by Tim Murphy, former Gov. Mitt Romney's Health and Human Services Secretary, at a forum held by the Pioneer Institute. (June 2006)

The Third Wave of Massachusetts Health Care Reform
Health Affairs article by John McDonough, Brian Rosman, Fawn Phelps, and Melissa Shannon on the process leading to Massachusetts health reform and its major features (September 2006)

The Massachusetts Model: An Artful Balance
Health Affairs article by Nancy Turnbull on the challenges facing Massachusetts policymakers as implementation of the state's health reform law began. (September 2006)

Massachusetts Health Care Reform: A Look at the Issues
Health Affairs article by John Holahan and Linda Blumberg on major features of the health reform law, implementation issues, and its applicability elsewhere. (September 2006)

The Massachusetts Approach: A New Way to Restructure State Health Insurance Markets and Public Programs
Health Affairs article by Edmund F. Haislmaier and Nina Owcharenko on the state's groundbreaking public-private approach to health reform. (November 2006)

Massachusetts Health Reform: Employers, Lower-Wage Workers and Universal Coverage
Issue brief by Laurie Felland, Debra Draper, and Allison Liebhaber of the Center for Studying Health System Change that summarizes interviews with Massachusetts health care leaders to understand how the reform law would affect employers decisions to offer health insurance coverage and concerns regarding the affordability of coverage. (July 2007) 

Revisiting Massachusetts Health Reform:18 Months Later
Community Catalyst report by Christine Barber and Michael Miller, examining early enrollment, coverage and implementation issues from a consumer advocacy perspective. (December 2007)

Massachusetts Health Reform Implementation: Major Progress and Future Challenges
Health Affairs article by John McDonough, Brian Rosman, Mehreen Butt, Lindsey Tucker, and Lisa Kaplan Howe on the first two years of implementation. (June 2008)