Primary tabs

in favor
against

The Massachusetts plan definitely is working well -- 98% of residents are covered, and costs have risen more slowly there than in most other states – and it’s doing some things differently that the ACA or its replacement could copy.

Zetema PanelistZetema Panelist In Favor

The Massachusetts plan isn’t working all that well. Costs have risen more than expected, and the state has made changes to the original plan nearly every other year because of problems that have needed fixing.

Zetema PanelistZetema Panelist Against

Massachusetts put a cap on its total medical cost increases, linking them (successfully) to growth in the state’s economy. If the US did that with payment rates under the ACA, costs would grow more slowly and the plan would be considered a success.

Zetema PanelistZetema Panelist In Favor

The US has never been able to impose caps on healthcare costs. Massachusetts residents are more politically similar than Americans in general are. It’s a wealthy state with a high tax base. The plan is funded at a higher level than the ACA, which accounts for its success. We can’t make the ACA or any plan work at the federal or state levels without spending even more taxpayer money.

Zetema PanelistZetema Panelist Against

Massachusetts had higher initial penalties for failing to enroll, which boosted enrollment and reduced adverse selection and caused more healthy people to join, vs. the ACA experience. Massachusetts gave residents fewer choices about waiting to enroll, while the ACA allowed many exceptions to the standard enrollment period, so some people waited till they got sick to sign up.

Zetema PanelistZetema Panelist In Favor

Massachusetts’ rules and penalties are just a stronger form of the ACA’s individual mandate. There are better ways to ensure that health people join the risk pool without infringing on personal choice, such as the powerful incentives used by Medicare for its drug benefit (Part D).

Zetema PanelistZetema Panelist Against

The Massachusetts program has motivated provider organizations to become more efficient.

Zetema PanelistZetema Panelist In Favor

Providers in states that didn’t have the Massachusetts program also became more efficient, so it wasn’t due to the reform plan.  

Zetema PanelistZetema Panelist Against

Other states, at least the mid-sized and larger ones, could replicate Massachusetts’ experience if they could find the political will to do so. 

Zetema PanelistZetema Panelist In Favor

Massachusetts began with better overall access and a well-functioning charity care program before introducing the new plan, as well as an administrative infrastructure funded by a high tax base. Its success wouldn’t necessarily translate to other states or to the US as a whole. 

Zetema PanelistZetema Panelist Against

What do you think?

If Massachusetts’ healthcare reform is working well and was the model for Obamacare, wouldn’t copying its features more exactly make whatever replaces the Affordable Care Act (ACA) work just as well?

If Massachusetts’ healthcare reform is working well and was the model for Obamacare, wouldn’t copying its features more exactly make whatever replaces the Affordable Care Act (ACA) work just as well?

You've already completed this survey. Thank you for participating!