About 6 years ago, I was appointed the Massachusetts Commissioner of Public Health just as the state’s groundbreaking health care legislation was on the verge of being implemented. Certain things we clearly anticipated. The Massachusetts Medicaid Program (known as Mass Health) would surely expand its eligibility criteria so that a few hundred thousand more residents could enroll. The country’s first insurance exchange—the Connector—would be formed to oversee the process of offering affordable private insurance to residents of all incomes levels. Within a matter of months, we fully expected that almost half a million more people in the Commonwealth would become insured—driving down the percentage of the uninsured to the lowest level in the nation. It was obvious to me that I had a front-row seat at an historic event with meaningful implications for the nation as well as our state.
What wasn’t so obvious was what the Department of Public Health and I had to do with all this. We were watching all the action but confined to the sidelines. Could public health assist in the implementation of health care reform? Even more important,would health care reform change the role and the work of public health?