Congress is facing a lot of questions right now as it builds a national health care reform plan: Should there be a robust public option? Is a strong employer mandate necessary? What additional protections should private insurance clients enjoy? What often gets overlooked is that many state-level reforms have already addressed some of these questions, providing important clues about what a national reform plan should look like.

Massachusetts’ experience with employer mandates -- designed to prevent businesses from “dumping” health coverage for employees -- is a case in point:

The Bay State’s 2006 landmark healthcare law, often seen as a model around the country, allowed businesses who chose not to cover their employees to get by with just a minimal fee. Yet even without the threat of a serious penalty, employee dumping has not been a problem, said architects of the Massachusetts plan.

Three years after the state passed its requirements, Massachusetts businesses have not canceled insurance plans at all. In fact,150,000 more residents are privately insured through their employers.

By proving that dumping can be prevented without a strong employer mandate, Massachusetts’ experience introduces flexibility for federal lawmakers. Of course, dumping is still a serious concern -- one the Massachusetts plan ultimately solved by limiting who can use the public option:

Workers whose employers helped them pay for decent insurance were disqualified from purchasing government-subsidized plans. And for low-income people who qualify but earn twice the poverty level or more, the government-subsidized insurance costs roughly the same as a typical worker’s share of an employer-subsidized private plan, providing little financial incentive for employees to seek a change.

Many would argue that such limits defeat the purpose of a public option, setting up an important choice for public option advocates to consider: should a public option be universally available, or are some restrictions acceptable in order to protect the larger economy and preserve employer-sponsored health plans?

These are not easy issues, but whatever the outcome, any federal healthcare reform bill will almost certainly be a better piece of legislation because Massachusetts and other states have led the way with groundbreaking reforms.