In an effort to assure health coverage for all of its citizens, Massachusetts passed health-care reform legislation in 2006, and more than 130,000 people who did not have coverage before are now insured.

Massachusetts estimates 372,000 citizens lacked health insurance before the program began. The federal government pegs that number at 500,000. New enrollees include people who qualified for and signed up for MassHealth, the state’s Medicaid program.

“It took three years to pass this law,” said Dick Powers, spokesperson for the Commonwealth Health Insurance Connector Authority, formed by the state to implement the program. “It will take some time to have close to all adults in the state enrolled. It’s a marathon, not a sprint.”

July 1 marked the first day the state required most residents to enroll in a health plan. Children were not included in the bill.

The state approved 42 Commonwealth Choice health plans for consumers and employers. The typically uninsured person in Massachusetts, a 37-year-old, can purchase a CommChoice plan in the most expensive region of the state for as little as $164 per month.

By the end of the year, citizens must have a policy or forfeit a $219 personal deduction on their income tax. In future years, the penalty will be higher. Likewise, employers with 11 or more full-time equivalent positions must offer health insurance or pay $295 per employee per year into a state fund.

The state will subsidize payment of Commonwealth Care policies for people earning less than $30,630 annually. For anyone earning the federal poverty level or less, the state will pay the premiums, and the person will be responsible for a minimal co-pay for services. Those earning between 100 percent and 300 percent of the poverty level will receive a partial subsidy, with premiums ranging from $18 to $106 per month. Policies cover inpatient services; preventive, primary, specialty and emergency care; vision care; prescription drugs; mental health services; and some dental coverage.

The Massachusetts Hospital Association, hospitals, insurers and other organizations formed the Massachusetts Health Care Reform Coalition, which has worked to educate the public about health-care reform and encourage people to sign up for a plan.

“People are responding to our outreach efforts and clearly recognize that they are better protected when they have health insurance,” said Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector Authority, in a written statement.

The Massachusetts Nurses Association (MNA) has not taken an official position about the program, said spokesperson David Schildmeier. MNA is working to pass a state constitutional amendment to make health care a fundamental right.

“We are in support of a single-payer health-care system and see this as a positive step in addressing incrementally some of the issues associated with caring for the uninsured,” Schildmeier said. “But a single-payer system is the only system that ultimately covers everyone and covers them at a low cost with quality.”

The Massachusetts plan continues using the private-industry, multipayer approach to which Americans are accustomed. A poll, conducted by the Kaiser Family Foundation, the Harvard School of Public Health and the Blue Cross Blue Shield of Massachusetts Foundation found that 67 percent of state residents aware of the law supported it and 16 percent opposed it.

Ninety percent of supporters said it is the right thing to do, and 79 percent believe broader coverage will keep costs down by providing more incentives for preventive care.

Among opponents, 72 percent said people shouldn’t be required to buy insurance if they cannot afford it, and 61 percent said they did not want insurance.

Twenty-four percent of those surveyed said the law will benefit them personally, about twice as many as those who indicated it will hurt them. Most residents, 62 percent, do not expect the law to have any personal impact. However, 66 percent of respondents believe the law will cause their taxes to go up in the future.