Massachusetts’ proposed Paid Sick Days Act is a natural partner to bring cost control to the Commonwealth’s expanded health care system. The Massachusetts Health Care Reform Law’s universal health care requirement extended health insurance to nearly 440,000 individuals in its first two years (Commonwealth Health Insurance Connector Authority 2008). According to the Massachusetts Department of Revenue, the program has nearly eliminated uninsured status among state taxpayers.1 However, the program’s cost has been much higher than anticipated. Funding for Fiscal Year 2008 was increased by nearly one-third through a supplemental budget request, to $625 million, and the Fiscal Year 2009 budget pegs the program at forty percent more: $869 million.