Excerpt: If there's a model for how President-elect Barack Obama's health care policy could play out in the real world and the political challenges it faces, look no further than Massachusetts. While Obama has been vague about the details of his health plan, the next administration's health care designs reflect what has been put in place in Massachusetts since then-Gov. Mitt Romney signed a universal health care law in 2006. Both plans leave the employer-based health care system alone while providing individuals access to cheaper insurance rates in the group market and penalizing employers that do not offer health insurance.

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