The Massachusetts Experience

This report from Harvard University researchers analyzes the three-year, on-going experience following the Massachusetts Health Care Reform Act of 2006. Data for this study has been acquired from multiple sources including the Urban Institute, the Massachusetts State Government, and the United States Census Bureau.

In the wake of the reform efforts, nearly 300,000 residents, representing between 67 percent to 80 percent of the uninsured population, have obtained health insurance through the state’s Medicaid or Commonwealth Connector programs. The Connector was a new public agency tasked with developing policy and regulatory reform. Through the Connector’s main programs, Commonwealth Care (a subsidized insurance plan for individuals earning less than 300% Federal Poverty Level) and Commonwealth Choice (an unsubsidized marketplace similar to the Federal Employees Health Benefits Program), individuals are expected to find coverage. In fact, approximately 40,000 individuals have obtained private insurance (either through the regular market or the Commonwhealth Choice program) and 176,000 have obtained insurance through Commonwealth Care.

The uninsured rate in Massachusetts is now estimated to be between 2.5 percent and 5 percent; this is down from approximately ten percent. The number of patients receiving uncompensated care has fallen 36 percent (a number that is half of what is to be expected).  In analysis of public opinion, a large percentage of Massachusetts residents support the individual and employer mandates included in the health reform. However; nearly two-thirds of those individuals who were uninsured in the year prior to the reform (i.e. those who are affected by the program) are dissatisfied with the mandates.

Commentary:

In this article, a hodgepodge of data comes together behind the argument that the Massachusetts health reform has not and will not work. The study’s  authors include two of the founders of Physicians for a National Health Program, a group dedicated to advocacy for universal health care via a single payer model.  While they demonstrate that the Massachusetts reform has not yet achieved universal health care, they fail to mention that the reform plan did not include two essential components – guaranteed issue and community rating – necessary for a public plan to co-exist on a fair playing field with private insurance options.

Massachusetts Health Reform (Wikipedia)

 

by

Cedric K. Dark, MD, MPH