In addition to closing a budget gap of close to $2 billion, Massachusetts is tackling another tough fiscal issue: reining in the costs of its first-in-the-nation universal health insurance law.

Five years after the law, similar in many ways to the federal reform measure, was enacted in 2006, 98 percent of adults and nearly 100 percent of children have health insurance coverage, Christine Vestal reports at But costs have soared, and Massachusetts now spends 40 percent of its budget on health care.

Gov. Deval Patrick has introduced legislation to impose price controls on hospitals and other medical providers, but he warned that the job won’t be easy. “If you think [achieving universal] access was hard, wait until you take on cost control.”

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