Massachusetts led the nation in expanding healthcare coverage and reforming its payment and delivery models, with considerable success. The Affordable Care Act (ACA) provided Massachusetts with new tools and new funding, while imposing new requirements. Now, almost 10 years after the passage of Chapter 58, its state healthcare reform law, and five years after the passage of the ACA, Massachusetts has the opportunity to reevaluate its system of coverage and consider the changes required to assure a more rational, affordable continuum of coverage, as well as a stronger foundation for its payment and delivery system reform.

In an issue brief for the Blue Cross Blue Shield of Massachusetts Foundation, Manatt Health reviews the coverage goals Massachusetts may seek to address through a Basic Health Program (BHP) or 1332 waiver, the federal requirements related to these vehicles for innovation, and specific program modifications the state may consider to further tailor healthcare reform in the Commonwealth.