The commonwealth of Massachusetts, one of the 50 states in the United States of America, has achieved near universal health coverage of its 6.6 million residents after a landmark reform made health insurance mandatory for all residents in 2006. The reform was only the latest step in a sequence of national and state programs that successively enrolled more people in private and public health insurance programs over a period of four decades. Massachusetts passed chapter 58 of the acts of 2006, the Massachusetts health care reform law, on April 12, 2006, and over a five-year period, more than 400,000 previously uninsured residents were provided with comprehensive health benefits. As of 2012, 98.2 percent of the population is covered, including 99.8 percent of children. Massachusetts has the highest rate of health insurance coverage of any state in the country. The program has widespread popular support, and it served as a model for the design of President Obama's affordable care act, which established a plan for mandatory coverage on a national basis for the first time in the United States. This report will briefly describe the reform and its context, but will focus for purposes of simplicity on the operational details of the mass health program of health insurance for the poor. A discussion of the administration and management of Mass Health can offer a glimpse into the inner workings of all other insurance plans in the commonwealth. Mass health, private insurance, and Commonwealth Care share similar tools, controls, and strategies.
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