Editor's Corner

State governments are at a delicate point in the healthcare reform process. Officials have proposed some fairly radical changes to the way their health insurance markets work, but haven't had time to prove their points yet.

Massachusetts, however, is supposed to change all of that. As its new health insurance requirements roll out this summer--and the rolls of the state's uninsured shrink--Massachusetts will pioneer a model that could change the course of the U.S. healthcare system for decades. If it works, other states will have a much easier time moving forward, and given the current political climate, there's little doubt that they'll go for it.

The question, however, is whether the Massachusetts roll-out will prove to offer a workable example or not. One naysayer, the Foundation for Taxpayer and Consumer Rights, argues that the plans are unworkable given the real costs imposed by the state-negotiated basic health plan (see story below).

If FTCR is right, this isn't great news for still-emerging reform plans brewing in other states. If consumers can't really use their coverage--yet face state penalties if they don't buy--the closely-watched Massachusetts program may face serious challenges not long after its launch. I imagine Gov. Deval Patrick (D) will counter that some coverage is better than none, but somehow, I don't think that will play well with the peanut gallery.

If Massachusetts stumbles, it could easily change the way other copycat states manage their health coverage expansion efforts. For example, it could mean that other coverage strategies--such as wider eligibility for Medicaid--become more popular than Massachusetts' "bare bones" commercial coverage model. Meanwhile, if the state's reforms are perceived as a major failure, other state efforts could get bogged down or cease entirely. That's the problem with bellwether states--while they can play a big role in catalyzing change, the rest of the industry has to live with their example, for better or worse.

All in all, the possibility that Massachusetts reforms might face cost problems with its roll-out raises the stakes considerably. If you're a fan of health coverage change, just hope that trend-setting Massachusetts state leaders can carry the ball. - Anne