Implementing health care reform in Massachusetts: strategic lessons learned.

Massachusetts has been in continuous campaign mode on health reform since 2004, when then Gov. Mitt Romney (R) and advocacy groups from both parties began to promote universal coverage. The state has already enacted two sets of reforms (in 2006 and 2008), and it may soon consider an all-payer proposal aimed at containing costs. Much remains to be done, but the political strategy of enacting reform in stages has already produced big gains and momentum to do more.