In April 2006, Massachusetts passed wide-ranging health care legislation, with a goal of universal insurance coverage. Three years later, the state has 97 percent coverage, the highest in the nation. The law:
• Required people 19 and older to buy health insurance, if "affordable coverage" was available, or pay a tax penalty ranging from $204 to $1,068 a year, depending on income.
• Required employers who have more than 10 full-time employees to contribute toward their workers' health insurance or pay $295 per employee a year (to discourage businesses from dumping employees into the state's subsidized plans).
• Created a subsidized health insurance program, called Commonwealth Care, for adults who have incomes up to 300 percent of the federal poverty level -- $32,508 for an individual -- and have no access to other insurance.
• Expanded the state's Medicaid program, known as MassHealth, to cover children in families that have incomes up to 300 percent of the federal poverty level of $66,168 for a family of four.
• Created the Commonwealth Health Insurance Connector Authority to set rules for Commonwealth Care plans and oversee an online exchange to help people shop for insurance. The Connector also approves non-subsidized plans, called Commonwealth Choice plans, for people who want to buy individual insurance policies but do not qualify for subsidies.
• Converted the previous uncompensated care pool to a health safety net, which reimburses hospitals and community health centers for part of the costs of those who remain uninsured and those who are underinsured.Sources: Commonwealth Connector, the Kaiser Family Foundation