State officials finalizing plans to celebrate 20 years of landmark health care law

The state’s 2006 landmark health care law has been referred to as “Chapter 58,” or “Romneycare,” after the governor who signed it.

Ron Mariano calls it a “pain in the ass.” It’s a joking reference to all the work that went into crafting the bipartisan law, which turns 20 years old next month. “It was a grind,” he recalled during an interview in the speaker’s office.

Planning is underway to celebrate its anniversary inside Faneuil Hall, where Gov. Mitt Romney signed the law with a fife and drum corps in tow. Next month’s celebration, led by Gov. Maura Healey’s office and the Health Connector, an entity created by the law, is set for Monday, April 13. (The actual day that the law was signed, April 12, is a Sunday this year.)

Healey is scheduled to speak. Romney and former Gov. Deval Patrick, who implemented the law, are both attending the celebration. Organizers also plan to have a panel of experts and people who worked behind the scenes on the law.

Among the people who directly worked on the law, Mariano is one of the last officials – if not the last – left standing inside the State House. Romney, after two runs for president and a stint in the U.S. Senate, is now retired; former House Speaker Sal DiMasi and ex-Senate President Robert Travaglini have left the building; and U.S. Sen. Ted Kennedy passed away in 2009 while working to help pass what eventually became known as “Obamacare” at the federal level.

At the time, Mariano (D-Quincy) was the chair of the Financial Services Committee at the time, and had previously worked on the Insurance Committee. “There was all sorts of pressure from the feds,” Mariano recalled. “Kennedy was putting pressure on Trav and Sal to get something done. Everyone was viewing this as a major effort that could potentially be a game changer for how we do health care. That became apparent. Everyone was watching us back then.”

Mariano remembered the missed starts and miscommunications, and colleagues who “weren’t the easiest to work with.” He would come into DiMasi’s office after a meeting, upset at the lack of progress. “I was getting good at throwing my notebook from the door to the middle of the table just to get his attention if he was busy. And he would look at me and say, ‘Abbiate pazienza. Have patience, have patience.’ That’s all he’d say to me. That was about the limit of my Italian.”

Mariano called it the most difficult bill he ever worked on, but it was the “foundation for everything” afterwards. “It whetted my appetite for tackling the big problems because it really taught you to look at all the different angles,” he said.

John McDonough, who served as executive director of the advocacy group Health Care For All, said at the time the state was spurred by the possibility of a massive budget hole created by an expected loss of federal Medicaid dollars. There was also the threat of a ballot question, which collected 120,000 signatures with the help of volunteers.

McDonough, who went on to work for Kennedy in D.C., considers the law a success because it focused on health care access and getting as close as possible to universal health care coverage. “It preserved and increased the federal financing to support the new structure. You can’t blame [Chapter] 58 for not controlling costs, because that was never part of what was being done in this,” he said. 

For his part, McDonough is happy to call it “Romneycare,” even though he worked for the Romney’s Democratic opponent in the 2002 race for governor. One of the reasons the law got done, according to McDonough, was because President George W. Bush was willing and eager to help Romney, and “wanted to give him a leg up” in running for president.

“Had we had a Democratic governor, we never would have gotten the sweet deal we got in 2006,” McDonough said.

If you want some pomp to go with the circumstance, here is the State House News Service story from that day: “Marching in to the tune of "Yankee Doodle Dandy" – led by a dozen drummers dressed in Colonial garb – legislative leaders, US Sen. Edward Kennedy, several administrative secretaries, and the Heritage Foundation's Robert Moffit shared the stage with Romney for today's event.” If you’re planning to be in Faneuil Hall next month, drop me a line: [email protected].

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