A new report published recently online in the journal Health Affairs showed that 94.2 percent of the non-elderly population in Massachusetts had health insurance, a significant increase over the 86.6 percent who were insured prior to the state's health reforms.
But the report "Massachusetts Health Reforms: Uninsurance Remains Low, Self-Reported Health Status Improves As State Prepares To Tackle Costs" by Sharon K. Long, Karen Stockley and Heather Dahlen had both good news and bad news. While respondents to a 2010 survey self-reported improvement in their health status, the cost of insurance has continued to skyrocket, because legislators deliberately chose to put off addressing the rising costs of care when it wrote the 2006 law.
[See also: Latest census figures show 49.9M lack health insurance.]
"Just as Massachusetts's 2006 health reform legislation provided the template for the Affordable Care Act...the state's experience under that legislation provides an example of the potential gains under federal health reform," noted the authors. "It is likely that the path to near-universal coverage nationally will be slower and bumpier than it was for Massachusetts in 2006. Yet the findings for Massachusetts are a reminder that major gains in coverage and associated benefits are possible."
To obtain the 2010 data, the authors conducted a randomly sampled telephone survey of approximately 3,000 nonelderly adults in the state. With a 39 percent response rate, the sample included households with cell phones as well as landlines. The authors compared the 2010 data with previous annual surveys from 2006 through 2009.
The report also noted that there was not a significant shift in the source of insurance for adults between 2006 and 2010. Employers continued to be the largest source of insurance for state residents and even increased from 64.4 percent of adults covered in 2006 to 68 percent in 2010.
[See also: Employers skeptical of healthcare reform, but few project dropping health insurance coverage.]
"In 2010, as in earlier years, there was no evidence of public coverage 'crowding out' employer-sponsored insurance under health reform in Massachusetts," the report noted.
Other key findings of the study:
- Although access to care was generally better in 2010 than 2006, the number of respondents who had reported a general doctor visit declined by 3.5 percentage points between 2009 and 2010, perhaps reflecting increases in the use of specialists and preventive care under reform.
- In 2010, 6.1 percent of respondents said that their level of out-of-pocket health spending was at least 10 percent of their family income - a decline from 9.8 percent in 2006. The cost to employees of premiums, however, increased between 2006 and 2010 from $1,011 to $1,200 for single coverage and $3,128 to $3,444 for family coverage.
- Overall, the authors found that in Massachusetts coverage and access to care remain strong, and the effectiveness of healthcare delivery continues to improve. The affordability of healthcare remains a challenge as the Bay State, like the rest of the nation, continues to struggle with rising care costs.
One interesting shift occurred in the opinions of Massachusetts' residents of the health insurance reforms. While two-thirds of residents still approved of the reforms, a marked shift has occurred among non-supporters from a neutral position to one of opposing the reforms. In 2010, 26.9 percent of the state's residents opposed the legislation, up from only 17 percent who opposed it in 2006.
The authors noted that polls show support for and opposition to the national reforms are split nearly evenly (41 percent in favor of the reforms and 46 percent opposed).
As a result, the authors concluded, "It is likely that the path to near-universal coverage nationally will be slower and bumpier than it was for Massachusetts in 2006. Yet the findings for Massachusetts are a reminder that major gains in coverage and associated benefits are possible."