What we learned from Massachusetts
Last week, the Blue Cross Blue Shield of Massachusetts Foundation released a report by the Urban Institute analyzing the impact of the Massachusetts’s health reform law over the past year. By all accounts, access, quality, and affordability have improved for all Bay Staters both since the inception of the bill in April 2006 and over the past year.
In April 2006, Massachusetts passed An Act Providing Access to Affordable, Quality, Accountable Health Care (Chapter 58 of the Acts of 2006). The main goals of the law were to move the state to near universal insurance coverage and improve access to care. In order to track the law’s impact, the Blue Cross Blue Shield of Massachusetts Foundation teamed up with the Urban Institute to survey the residents of Massachusetts every year to determine how well the health reform law was meeting its goals. According to this year’s survey, Chapter 58 is well on its way.
Under health reform in Massachusetts, health insurance coverage of non-elderly adults has risen to 95.2 percent, up from 87.5 percent in the fall of 2006. That is an increase of 7.7 percent, with only 4.8 percent of non-elderly adults uninsured in the fall of 2009. Moreover, despite the economic downturn between the fall of 2008 and the fall of 2009, uninsurance in Massachusetts remained at historically low levels. And unlike the rest of the country, Massachusetts’s robust system of public coverage, strengthened through health reform, provided additional protection against loss of job-based health insurance.
There were also significant increases in access and affordability of care for all non-elderly adults, but several of the strongest gains were seen by some of the most vulnerable populations such as lower-income adults and adults with a chronic health condition.
For example, insurance coverage rose by 14.1 percentage points for lower-income adults and 6.6 percentage points for adults with a chronic health condition between fall 2006 and fall 2009.
Middle-class adults also saw significant gains in coverage, up 4.7 percentage points as well as gains in health care access. The report also found that Massachusetts's health reform law has eliminated or narrowed some of the racial and ethnic disparities in health coverage, such as access to and affordability of coverage, that were present before the inception of the bill in 2006.
As a result of the successes the Massachusetts’s health reform law, support for the law has remained high throughout the state, with 67.0 percent of non-elderly adults supporting health reform in fall of 2009.
Why are these findings important to the national legislation, Patient Protection and Affordable Care Act, passed this past March? Much of the legislation was based on the health reform passed in Massachusetts. As we begin to implement the new law, we can look to Massachusetts to see what has worked and what has not worked, to guide our implementation work. But it is apparent from these numbers that the Massachusetts’s law has been a success and continues to benefit the residents of the state, just as federal health reform will do for the American people.