In the first year of an effort to move Massachusetts to universal healthcare coverage, a report by the Commonwealth Fund finds that the number of working-age adults in Massachusetts without insurance has been reduced by almost half - from 14 percent in 2006 to 7 percent in 2007.
The study, "On the Road to Universal Coverage: Impacts of Reform in Massachusetts at One Year," was authored by Sharon K. Long of the Urban Institute and supported by the Blue Cross Blue Shield of Massachusetts Foundation and Robert Wood Johnson Foundation.
The study conducted two rounds of interviews with adults in Massachusetts before and after the implementation of healthcare insurance reforms.
The survey found that in adults with incomes below 300 percent of the poverty level (the target population for CommCare), the rate of uninsured dropped by nearly 11 percentage points to 13 percent in fall 2007. Among adults with income less than 100 percent of the poverty level and eligible for fully subsidized coverage under CommCare, the rate of uninsured dropped by more than two-thirds, to 10 percent in fall 2007.
For higher-income adults less likely to be uninsured in 2006 and not eligible for subsidized coverage, the drop was smaller but still significant, the survey found.
The survey revealed that nearly 93 percent of all non-elderly adults in Massachusetts were insured in 2007.
Among all adults, 7 percent reported that the Commonwealth's mandate for individual insurance coverage had influenced their insurance coverage decision in fall 2007; 11 percent of low-income adults reported it had affected their insurance decision, and among higher-income adults, 4 percent reported it affected their coverage decision.
Despite concerns that the plan would "crowd out" existing coverage, employer coverage remained stable for adults overall and increased by 5 percentage points for low-income adults, the survey found.
In addition to improvements in insurance coverage, the study also found significant gains in access to care. More adults reported having a usual source of care and participating in a preventive care visit, and the number of adults reporting high out-of-pocket spending and medical bill problems dropped.
The study found that support for Massachusetts' reform efforts is high, with 71 percent of all adults being in favor of the plan.
It remains an open question as to whether the higher cost of failing to comply with the individual mandate in 2009 and beyond, along with the state's efforts to lower the cost of insurance for most uninsured adults, will provide strong enough incentives to encourage the remaining uninsured adults to obtain coverage. What do you think? E-mail Associate Editor Molly Merrill at molly.merrill@medtechpublishing.com.