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Angie Drobnic Holan
By Angie Drobnic Holan March 2, 2011

Deval Patrick said the Massachusetts health care law added 1 percent to the state budget.

Massachusetts overhauled its health care laws in 2006 to work toward universal coverage. Many consider it a model for national health care reform -- even critics, who say that Massachusetts’ problems with cost controls mean the national plan will have similar problems.

But Deval Patrick, the Democratic governor of the state, said the cost overruns aren’t as dramatic as some are claiming, when asked about it on This Week with Christiane Amanpour.

"Actually, it's added about 1 percent to our state budget, which is not what is generally reported on out there, but that is the truth," Patrick said.

Patrick added that the plan in Massachusetts was to cover the uninsured and then address cost controls. "And just as we have shown the nation how to provide universal care through a public-private model, I think we can crack the code on health care costs as well," he said.

Patrick promoted his own plan for reducing costs by paying doctors and hospitals for healthy outcomes, not per procedure.

We were interested in fact-checking Patrick’s statement that the 2006 Massachusetts health care law, signed by then-Gov. Mitt Romney, had added only 1 percent to the state budget.

We contacted Patrick’s office but didn’t hear back. Meanwhile, we tracked the claim back to a report from the Massachusetts Taxpayers’ Foundation, a nonpartisan policy research group backed by business that regularly analyzes state fiscal issues.

A report published in 2009 found that the state’s share of health care spending increased by $353 million in fiscal year 2010. The state’s entire budget is roughly $30 billion, so that comes out to about 1 percent, said Michael Widmer, the group’s president. He said the group has not updated the analysis with more recent numbers but has seen nothing to indicate the trend is any different.

There’s some fine print to explain about the group’s analysis, though. The foundation arrived at its number by adding health care spending increases for expanding coverage. But it also subtracted money the state would have spent under the old system on care for the uninsured and the state’s old Medicaid program.

An analysis by Michael Tanner of the libertarian Cato Institute in 2009 took issue with the study’s focus solely on the state budget. The federal government significantly increased Medicaid aid to Massachusetts as a result of the new law. Additionally, businesses and individuals had to spend more on insurance to satisfy new requirements that everyone have health insurance.

Widmer of the Massachusetts Taxpayers Foundation agreed that the federal government did pay more money for the Massachusetts health plan. Also, some of the uninsured also paid for care that the state paid for before, he said.

"That’s why the piece around the state budget has always been modest," Widmer said."We’re not trying to pretend it didn’t cost any additional money to insure 400,000 additional people."

Patrick said his state’s health care law "added about 1 percent to our state budget," and an independent analysis confirms that. There were additional costs for the health care plan outside of the state budget, so Patrick was right as far as the state budget goes. But because it's only one piece of a picture that includes increased federal spending, we rate his statement Mostly True.

Our Sources

Massachusetts Taxpayers Foundation, Massachusetts Health Reform: The Myth of Uncontrolled Costs, May 2009

The Providence Journal, Busting the Bay State: Hiding the cost of health reform, by Michael Cannon, Aug. 9, 2009

Commonwealth of Massachusetts, State Budget documents, various years

The New England Journal of Medicine, Massachusetts Health Care Reform — Near-Universal Coverage at What Cost?, Nov. 19, 2009

PolitiFact, Beck claims universal health care is driving Massachusetts' deficit, Nov. 10, 2009


The Associated Press, Gov. Patrick to pitch Mass. health care cost plans, Feb. 28, 2011

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Deval Patrick said the Massachusetts health care law added 1 percent to the state budget.

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