CAMBRIDGE, Mass – A chronic nerve condition in his neck and recurring stomachaches dogged Joe Rothfarb until the 25-year-old left California for Massachusetts, where an ambitious new state law is opening doors once closed to many seeking affordable medical care.

The frustrating search for health insurance in California thrust the former rock musician into a Catch-22 familiar to millions of Americans: Undergoing diagnostic tests meant submitting claims to pay the medical bills, which caused one insurer to refuse to renew Rothfarb's policy because he was tabbed as having a pre-existing condition.

His move to Boston a year ago to do graduate studies in social work at Boston University changed all that. Last March, Rothfarb became one of more than 150,000 previously uninsured state residents to gain affordable coverage under a novel universal health care program now in its first year. The program is attracting intense scrutiny from officials in Sacramento and other state capitols considering ways to cover the growing ranks of the uninsured.

State officials and health care experts say the Massachusetts law has a good chance of achieving that goal by using both carrots and sticks. It is less clear whether its remedy would work in a state like California where money is scarce and the uninsured make up a larger share of the population.

In addition, Massachusetts might be strapped in a few years when it has to confront perhaps the most intractable health care problem of all: the relentlessly upward spiral of medical costs that every year forces more and more Americans to fend for themselves.

“Clearly, what's going to have to happen in the long run is more money will have to be injected in the program,” said Jonathan Gruber, an economist at the Massachusetts Institute of Technology who helped to write the state's plan. “We don't have to in the next year or two, but if you look five or 10 years down the road, if this program is going to continue to exist, it's going to take more money to keep it going.”

Polls in Massachusetts show that the program enjoys broad support.

The Rev. Huron Hamilton, pastor of the inner-city Roxbury Presbyterian Church and president of the Greater Boston Interfaith Organization, described his state's health plan as “the best public policy program for the poor in the country.”

Asked to explain its enactment, Hamilton said: “My theological answer is that God happened to be in the details. The practical answer is that timing is everything.”

The business community, which is bearing part of the burden of financing the program, is more guarded in its appraisal but remains generally supportive.

Rothfarb's insurance dilemma is familiar to 47 million uninsured Americans. It has bedeviled policymakers and polarized politicians at all levels for more than a decade. But in April 2006, Massachusetts' Republican governor and Democratic legislature passed a bill that reached across ideological lines.

Conservatives praised the bill for including tough steps to make the state's health insurance market function more efficiently and fairly; liberals liked that it provided subsidies to individuals and families of modest means.

The plan requires every Massachusetts resident to obtain health coverage by the end of this year or lose a state tax break worth more than $200. For residents who make too much money to qualify for Medicaid but whose incomes fall short of 300 percent of the poverty line – about $29,412 for an individual – there are subsidized premiums.

For uninsured individuals and families whose incomes are above that point, a new state agency called the Connector Authority has assembled a range of options that in some cases include prescription drug coverage and that offer premiums ranging from slightly more than $100 a month for healthy young adults to more than $1,000 for older families with more complicated medical situations.

The new law is considered a crowning achievement of former Gov. Mitt Romney, now a Republican presidential candidate, but current Gov. Deval Patrick, a Democrat, has thrown the weight of his office behind the law's implementation. Patrick and the Connector Authority were instrumental in winning premium discounts from the insurers after initial bids to provide policies produced rates that seemed excessive. The rollback was crucial politically and economically. Affordability is key to winning public acceptance of the requirement that residents obtain coverage on their own or through their employers.

Businesses with more than 10 employees are required to offer coverage that workers can purchase with pretax dollars. Employers who refuse pay an annual assessment of $295 per worker into the state kitty to help finance the program.

Patrick has asked for $1.7 billion in the next fiscal year to finance the program, with the funds coming in part from an existing pool of money used by the state to pay hospitals and community medical clinics for providing medical care to uninsured indigents.

Another indispensable pot of money involves about $400 million in Medicaid funds that have been made available for the program under a waiver granted by the Bush administration. That waiver will soon expire, however, and the prospect of renegotiating it with the federal government introduces a critical note of uncertainty into the program's fiscal future.

Although the program's goal is universal coverage, its architects included a provision exempting individuals and families from the mandate if they cannot afford any acceptable policy.

The program is helping many who had been priced out of the health insurance market.

Rothfarb, the transplanted Californian, said that before his move to Massachusetts, he took a job of little interest to him with a manufacturer of testicular and breast implants and other prosthetic devices in Santa Barbara only because the position offered a group policy that seemed to meet his needs.

Now he pays $35 a month – with no deductibles but a $10 co-pay – for a policy that covers CT scans, specialists, routine care, drugs and physical therapy.

Rothfarb said the Massachusetts program “has encouraged me to pursue a career that's not reliant on benefits as part of the deal. I wouldn't have gone ahead doing my volunteer work or my work for a (nonprofit) had I known that for any significant amount of time I wouldn't have had a policy.”