Massachusetts is entering its sixth year of health reform, a reform similar to the federal law, although Massachusetts is not representative of the country in its income and other demographics, and its uninsured rate of non-Medicare eligible adults at the time of reform was only 11.4%, well below the national average. Health Affairs periodically publishes research looking at the aftermath of the Massachusetts reform and has recently done so again. (HA Article) The data for the research comes primarily from an annual survey of about 3,000 adults in the state, so it is not necessarily the highest quality information, but trends should be accurately identified, since errors should be similar from survey to survey.
Coverage remains high, with only 5.8% saying they didn’t have insurance, which is comprised of a few people who didn’t have insurance for the whole 12 months and more who didn’t have it for some period during the year. People were more likely to have a usual place of care and to have had a preventive care visit than in 2006, although the gain is somewhat slight. From 2009 to 2010 there was a drop in the use of emergency rooms and hospital stays, a decline for which the cause is unclear–better health from better access to primary care or more cost-sharing. In general, the survey continues to show improvements from 2006 in people feeling that they are able to get the care they needed, although this worsened slightly in 2010.
The survey also indicates that more adults in Massachusetts report their health as very good or excellent in 2010 than did in 2006, suggesting that overall health status has improved. Cost, however, continues to be a barrier to receipt of care, and premiums continue to rise faster than either inflation or economic growth. Although not dealt with in the survey or the article, we know from other sources that Massachusetts is spending far more on health care as a result of reform than was projected and is now struggling with how to rein in the excess costs. Good luck with that. And while support remains high at about 66% of adults, opposition has grown to 27%. Maybe people are wondering if the relatively small gains are worth the cost.