In April 2006, Gov. Mitt Romney signed landmark legislation that aimed to make Massachusetts the first state in the country with universal or near-universal health care coverage for all residents. “An Act Providing Access to Affordable, Quality, Accountable Health Care,” often known as Romneycare or by the shorthand Chapter 58 (its designation in that year’s laws), was a pathbreaking effort to address the persistent coverage gap in US health care.

As federal policies evolve and financial pressures intensify, Massachusetts confronts significant challenges in ensuring that health care remains accessible, affordable, and equitable.

In September 2025, we brought together health care providers, policymakers, patient advocates, and industry leaders to examine how the Commonwealth can respond and adapt.

With shifting federal policies, a changing funding landscape, and more frequent extreme weather events, how can the Commonwealth rise to the challenge of our changing climate?

In April and May 2025, we brought together the voices of environmental advocates, business leaders, energy experts, and municipal leadership from across Massachusetts to explore how the state charts a path forward.