It may come as a surprise that President Barack Obama and GOP vice presidential nominee Paul Ryan are pushing the same target rate for controlling federal spending on Medicare. Each would set it at half a percentage point higher than the growth rate of the economy -- the gross domestic product -- after a phase-in period.

Most of the headlines about the choice of Wisconsin Rep. Paul Ryan as running mate for presidential candidate Mitt Romney have screamed about how the author of the House budget plan would upend the Medicare program and upset seniors' certainty about healthcare. Ryan's plans for Medicaid, however, are more extreme and immediate.

Defying expectations, the Supreme Court issued a 5-4 ruling upholding the individual mandate and the Affordable Care Act in its entirety and limiting but not invalidating the Medicaid provision.

The state's political leaders appear to be striving for a status quo wherein a large number of citizens lack health insurance or the means to obtain it. Will that spark a shift among voters during the upcoming November elections?

Thanks to former governor Mitt Romney, healthcare reform is working in Massachusetts. In fact, the state is number one in the nation for coverage because of the pivotal individual mandate he promoted.