Last week, I provided some Massachusetts context to understand the dispute over mandatory coverage of contraceptives under the Affordable Care Act. The U.S. Conference of Catholic Bishops objected to a requirement that Catholic affiliated hospitals, universities, and other large employers (not including houses of worship) would have to provide free contraceptive coverage to their workers -- despite evidence that many such institutions, including Boston College, already do so.

The Obama Administration stepped back from the mushrooming controversy, freeing the institutions from providing coverage for contraceptives, though requiring their respective health insurers to do so.

After expressing initial approval, the Bishops pulled back and said the ruling did not satisfy their objections; various Republican Congressional leaders concurred, and took the matter a big step further. Last week, Freshman Senator Roy Blunt (R-MO) filed legislation to allow any employer, religiously affiliated or not, to refuse to cover any essential or preventive health service, not just contraceptives, based on the "religious belief or moral conviction" of the employer. Word from DC is that Blunt and allies will attempt to add the provision as an amendment to other legislation now moving through the Senate, perhaps as early as tomorrow.

Our own Senator Scott Brown (R-MA) has signed on as a co-sponsor of the Blunt legislation. Brown spokesperson John Donnelly has confirmed to the Washington Post that the Senator supports the Blunt legislation. So this is not an academic matter for Massachusetts voters.

Someone asked me recently: if the Affordable Care Act (ACA) is based on Massachusetts health reform, why should Massachusetts residents care if the law were repealed? What do we have to lose?

Good question. I went through major sections of the law, and came up with this list of three dozen substantive policies that would adversely affect Massachusetts residents if the ACA were repealed. Here is my list (ACA section in parentheses):

Each year, the United Health Foundation produces America's Health Rankings, gauging how well each state is doing on a variety of health care and health status measures.  It's a good set of snapshots on how each state is doing.  Last year, Massachusetts ranked #2 overall, and this year we're at #5.  Here's where the Commonwealth ranks the best (lower numbers are better):

Lack of health insurance, #1

Occupational fatalities, #1

Primary care physicians (per 100,000), #1

Premature deaths, #1

Infant mortality, #4

Early prenatal care, #5

Children's immunization coverage, #5

Public health funding, #5

Adult smoking, #5

And where do we not perform so well?

Gideon Gil, the Globe's earnest health editor with a melodic name, blew his trumpet and asked me to start this blog. He was a reader of a blog I started in 2005 when I was executive director of Health Care For All, Massachusetts' consumer health advocacy group. He liked it enough to think I might create some motion and emotion here at boston.com ...

Why Health Stew and what's this blog about? I like stew because lots of different ingredients get thrown in, often with delicious results. I'm interested in lots of things related to health care policy and politics, and how odd things can fit together. And I love soup.