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June 5, 2008On the Road to Universal Coverage: Impacts of Reform in Massachusetts at One Year |
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From The Commonwealth Fund: Massachusetts' ambitious health care reform plan has produced dramatic improvements in insurance coverage, finds a Commonwealth Fund--supported study in Health Affairs. In the first year, the rate of uninsured working-age adults in the state dropped by almost half, from 13 percent to 7 percent. This study reports the results of two rounds of interviews with adults ages 18 to 64 in Massachusetts---one conducted in fall 2006, just before implementation, and one in fall 2007, approximately one year after the reform efforts began. For adults with incomes below 300 percent of the federal poverty level, the uninsured rate dropped by nearly 11 percent-age points, from 24 percent uninsured in fall 2006 to 13 percent a year later. For lower-income individuals---those with incomes below 100 percent of poverty, and therefore eligible for fully subsidized coverage---the rate dropped by more than two-thirds, down to 10 percent uninsured in fall 2007. For higher-income adults, the drop was smaller (2 percentage points) but still significant; 97 percent of higher-income adults (those with incomes at or above 300% of poverty) were insured in fall 2007. Among all adults, 7 percent reported that the man-date had influenced their coverage decision, with more low-income adults than high-income adults reporting it had influenced their decision. A major concern about the plan was that the expansion of publicly subsidized programs would "crowd out" existing employer coverage---that is, fewer employers would offer coverage to their workers because it was offered elsewhere, or workers would drop employer coverage to take up public coverage.
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