Leaders from the public and private sectors as well as across the political spectrum came together to answer a question that long seemed unthinkable in Washington: Could we make health care coverage a reality for all?
Massachusetts proved to the nation that the answer was a resounding yes.
The lessons of that day went well beyond the policy. It was a tangible demonstration of what is possible when leaders of all perspectives come together, set aside partisanship, and focus on solving real problems. It showed that the government can do hard things. And that when Washington fails, it’s up to states to lead the way.
Those lessons resonate even more today than they did two decades ago.
There is no question Massachusetts faced a growing crisis before the health reform law was passed in 2006. More than 10 percent of residents lacked health insurance, and that number was rising as more businesses chose to drop employer-based coverage. Uninsured patients were increasingly relying on emergency rooms for primary care, driving up costs for everyone. It was unsustainable for families, businesses, and our state’s future.
So Massachusetts got to work.
The health reform law that followed was built on years of groundwork, innovation, and coalition building. It required leaders in government and nonprofit organizations, hospitals and insurers, business and labor — all working together. Elected leaders from across the political spectrum put the interests of people over political agendas. That willingness to get to yes, even when compromise was difficult, is what made Massachusetts the first to succeed where others had stalled.
The results? Undeniable.
The innovations that came out of this effort reshaped health care as we know it. The law created the Health Connector, the first state-based marketplace of its kind, designed to make it easier for individuals, families, and small businesses to find and afford coverage.
Today, nearly 98 percent of Massachusetts residents have health insurance, the best record in the nation for health care coverage. As more people got access to care, their health improved. By 2025, Massachusetts had moved from 15th to first place among states for the fewest premature deaths from treatable causes. Health reform is saving lives in Massachusetts.
We still have a lot of work to do to improve our health care system. But coverage is no longer the central challenge.
Families and businesses are now asking a different question: not whether they can get insurance, but whether they can afford it. High costs are now the existential crisis in health care. And with inaction at the federal level, it is up to states to lead once again.
Massachusetts is already taking action. We took the unprecedented step to eliminate the need for prior authorizations by insurance companies that delay care, frustrate patients, and increase costs. Now, when a patient with diabetes needs insulin, they get it — without delay. What’s more, in the same spirit as 20 years ago, we made this change by working with our health insurers, not against them. Massachusetts also capped out-of-pocket costs like co-pays and deductibles for the first time. And we have brought stakeholders to the table to develop the next round of health reform to lower costs for all.
As important as health care is, this moment is about something even bigger. We are two Massachusetts governors who served two decades apart. We represent different parties and perspectives. But we are united in this belief: Government can still do big things. It requires leaders from all parties to put aside partisan agendas, focus on what matters in people’s lives, and work together to get to yes.
Twenty years ago, Massachusetts showed the country what was possible when leaders do those things. This approach doesn’t have to be a relic of the past. It can be our future too. And if Washington won’t do it, the states can lead the way.
