Blog | Friday, January 27, 2012

QD: News Every Day--Does Massachusetts predict federal health care reform's impact?

Massachusetts residents reported that 94.2% of the state's adult nonelderly residents have health insurance, a significant increase over the 86.6 percent estimate of 2006, the year that Massachusetts's health reform bill went into effect.

Massachusetts health insurance penetration rates are far above an estimated 77.7% coverage rate for nonelderly adults nationwide, based on the National Health Interview Survey. Many look to Massachusetts as the bellwether for national health care reform, because that state's legislation was largely adopted into the federal Affordable Care Act.

The survey also showed first-time reductions in emergency department visits and hospital inpatient stays as well as improvements in self-reported health status. At the same time, there was a significant increase in premium costs paid by workers, reflecting Massachusetts' decision to delay efforts to lower health care costs in the 2006 legislation.

Results from the survey appeared online at Health Affairs and will appear in the journal's February 2012 issue. Results are based on a randomly sampled telephone survey of 3,000 nonelderly adults in the state. The response rate was 39%, and cell phones as well as landlines. The authors compared the 2010 data with previous annual surveys from 2006 through 2009.

Other key findings:
--68% reported coverage through an employer, a significant increase from 64.4% in 2006. The study finds no evidence that employers are dropping coverage under health reform.
--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% of respondents said that their level of out-of-pocket health spending was at least 10% of their family income, a decline from 9.8% in 2006. Premiums 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 health care delivery continues to improve. The affordability of health care remains a challenge as the Bay State, like the rest of the nation, continues to struggle with rising care costs.

"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," concluded 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."