Massachusetts groundbreaking 2006 health reform law served as a model in many respects for the insurance coverage provisions of the 2010 federal Patient Protection and Affordable Care Act. This report by Alan G. Raymond and funded by the Blue Cross Blue Shield of Massachusetts Foundation presents an overview of key lessons from Massachusetts that could be relevant to stakeholders working to implement health reform in other states and nationally. Key lessons include: ongoing stakeholder engagement in health reform facilitates implementation and helps overcome inevitable obstacles; and close coordination between Medicaid and new public insurance programs is needed to maximize enrollment and retention while also reducing redundancy and administrative costs.