IN THE STATES: Massachusetts Looks to Address the Linked Problems of Cost and Coverage

Two years ago, Massachusetts produced an impressive example of bi-partisan health reform when a Republican governor, Mitt Romney, agreed to cover all citizens and a Democratic legislature agreed to operate within a private market system. This week, that conversation continued, as leaders in Massachusetts examined different ways of controlling costs and changing the state's payment system. The goal is to make the state's commitment to coverage a sustainable reality.

Speaking before the joint Committee on Health Care Financing, Senate President Therese Murray outlined the major points of proposed legislation to control costs, noting that health care spending had grown 33 percent between 2002 and 2006, to $62.1 billion, Murray concluded "We cannot afford to stand by and let this continue."

On A Healthy Blog, John McDonough, executive director of Health Care for All,said that the hearing on costs signaled that "Health Reform Phase II is off and running." We're pleased to hear it, because for the state of Massachusetts (and while we're on the subject, for the United States), the goals of covering all citizens and controlling health care cost growth are inextricably linked. And while we often hear that reducing costs must be a condition for covering all Americans, we think that covering all Americans can actually be a step toward reducing costs over the long term. As the Boston Globe's Alice Dembner has noted on the paper's blog, White Coat Notes, the use of the state's free care pool has declined significantly from 2006 to 2007 since the reforms were enacted. That means an estimated savings of $240 million projected for the 2008 budget can be folded back into subsidies to help make insurance more affordable in Massachusetts.