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In addition to inking out the $295 per employee fee for companies that do not provide health benefits to workers, the governor vetoed provisions to restore dental benefits to adult MassHealth patients, saying it would prove too costly. 

Legislative leaders said they plan to immediately vote to override the vetoed sections. 

Criticisms and disappointments over the vetoes by supporters of the legislation detracted from what otherwise was a storybook bipartisan political event with the Republican governor standing with Democratic legislators and U.S. Sen. Edward M. Kennedy, D-Mass., to sign the bill. 

“You’ve given Massachusetts just what the doctor ordered,” Mr. Kennedy told an audience of political aides, medical professionals and state officials gathered for the elaborate signing ceremony at Faneuil Hall. “At long last, the impossible dream of health care for all will finally become a reality in our commonwealth, and quality care will truly be available and affordable for each and every man, woman and child in our state.” 

Mr. Romney generously praised House and Senate leaders who hammered out the compromises that produced the bill over many months and thanked Mr. Kennedy for coordinating the state program with federal officials who are expected to provide $385 million in federal demonstration funds to help implement the program. 

“Massachusetts is once again taking a giant step forward,” Mr. Romney said. He said the fees were not needed to implement or finance the health insurance plan. 

House Speaker Salvatore F. DiMasi, D-Boston, said the bill will expand MassHealth benefits for the poor and meet the goal of ensuring “good quality health care that is affordable and accessible for everyone, while helping to cut overall medical costs and ensuring higher reimbursements to hospitals and doctors.” 

The legislation will require all residents to obtain health insurance coverage by July 1, 2007, or face loss of personal tax exemptions and state assessments amounting to half the cost of an insurance policy. It also sets up state subsidies on a sliding scale for low-income earners to buy insurance, and it will allow sale of new types of less costly insurance plans with higher deductibles that lawmakers expect to come in at less than $300 per month for an individual. 

It also encourages companies to sign up for an insurance exchange that will allow workers at small firms to buy insurance using pretax payroll deductions that will save them about 25 percent on policies. It also allows the merger of small and medium group insurance plans to provide lower cost plans to small groups and businesses. 

Public health advocates, legislative supporters and representatives of the business community all criticized the governor for vetoing the $295 annual per employee fee that would be charged companies with more than 10 workers that do not provide health insurance coverage. Critics said it was an essential part of a compromise over shared responsibility between individuals and employers that broke a deadlock in the adoption of the legislation. The fee was expected to bring in $48 million annually to help fund the reforms. 

Mr. DiMasi, who had refused to accept individual mandates without an assessment on businesses that don’t provide insurance, said yesterday that, “To change anything will disturb the delicate balance that made this law possible.” He said he will lead an override to reinstate the fee. 

Michael J. Widmer of the Massachusetts Taxpayers Foundation, which represents businesses and was directly involved in key negotiations to produce the bill, said it would not have been adopted without agreement to the employer fee. “I think the assessment is absolutely fair because it is tied to the use of free care by employers who don’t offer health coverage. This simply equalizes the burden between those employers who do offer coverage and those who don’t.” 

“It only made sense for a candidate for president of the United States who is trying to appeal to the right wing,” said state Rep. James J. Marzilli, D-Arlington, of the vetoes. 

“I think its unfortunate that he has placed, in this case, his personal political ambitions and how that will play out, over what will make the system work in a fair way,” said state Sen. Richard T. Moore, D-Uxbridge, who helped broker the compromise aimed at sharing responsibility between employers and individuals. 

He said the elimination of dental benefits for poor adults was regrettable, noting that for many of them, dental care is important to making a good appearance to get jobs. 

While Mr. Moore has aimed for the bill to spawn lower cost insurance policies with monthly premiums as low as $200 for individuals, he said he now expects they will rise closer to $300 when they go on the market next year. 

Mr. Moore said, however, that the Joint Committee on Health Care Finance of which he is chairman will review those discount plans for affordability and quality, and he will seek revisions if needed before they are sold. 

Stacey Auger, a coordinator for Health Care for All, which pushed the legislation, said the group was “very disappointed” by the dental benefit cut, emphasizing that dental health is an important part of overall health care. Erin O’Leary, of Worcester, an advocate for low income families with Neighbor to Neighbor, said the dental benefit veto was discouraging to that group as well. Those benefits were eliminated in 2002 and should be reinstated now, she said. 

Hospitals that will get fewer uninsured patients welcomed the legislation. 

“If we are able to successfully implement this plan, and expand public and private coverage,” hospitals and patients will be better off, said Daniel P. Moen, president and CEO of Heywood Hospital in Gardner. “The more people who have an (insurance) card in their hand, the better off they are going to be and the better off the hospitals are going to be.” 

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