Here are some excerpts from this article in the March 26, 2008 Boston Globe:
Healthcare cost increases dominate Mass. budget debateAt root, the system cannot control costs because it explicitly rejects the market mechanisms that can do that in favor of state mandates that tell an individual how he may spend his own health care dollars and for what.
Controlling them said key to keeping universal coverage
When Massachusetts launched its landmark universal health insurance initiative nearly two years ago, the state put off addressing rising costs so it could expand coverage immediately. Now those costs are dominating the discussion as the state faces a recession and pivotal funding decisions that could make or break health reform.
...A larger issue will also come to a head by July 1: the need to secure a new three-year commitment from the federal government to pay for half the soaring cost of insurance subsidies. Massachusetts is seeking up to $1.5 billion, but the Bush administration has been cutting back federal payments to the states.
..."If we don't grapple seriously with the cost of healthcare, the support for reform will erode and the perception will become broader that it is unaffordable," said Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector, which oversees much of the reform effort.
It's always easy for a state to promise "coverage". What they can't do is provide actual quality, affordable care -- only the free market can do that.