Ten years ago, as medical costs soared, Massachusetts passed landmark legislation to tackle the problem.

The law created the Health Policy Commission, a first-of-its-kind watchdog agency to monitor rising costs. And it set a target to limit spending growth.

A decade later, that experiment in cost control has had mixed success. Health care spending has grown less rapidly — yet consumers and businesses are still grappling with higher costs each year.

Now, many health industry insiders and observers say, progress is stalling. They say the Health Policy Commission needs more power to hold the industry accountable for high spending and make care more affordable for all.

Amy Rosenthal, executive director of Health Care for All, said her consumer advocacy group constantly hears from people who can’t afford their medications or doctors’ appointments.

“Health care affordability is one of the things we hear about every single day in every single language in which we serve,” she said.

Forty-one percent of Massachusetts residents said they or their families had trouble paying for health care last year. And many of them are forgoing care that they need because it’s too expensive, according to a survey from the Center for Health Insurance and Analysis, or CHIA, a state agency that analyzes health care data and also was established through the 2012 law.

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