The results of an Urban Institute survey show that Massachusetts health care reform has cut the number of uninsured by half since its inception in 2006. Residents also reported lower out-of-pocket costs and low-income adults are now more likely to have regular checkups and dental visits. The initiative has cost nearly a third more than projected and costs are expected to rise. In addition, around 86,000 taxpayers paid fines for not signing up for health insurance.