Massachusetts’s health reform bill, which provided the template for the federal Affordable Care Act, went into effect in 2006. In a statewide survey taken in 2010, 94.2 percent of the state’s nonelderly (19–64) residents reported being covered, a significant increase over the 86.6 percent estimate of 2006. The survey is reported in a Health Affairs Web First article, by Sharon Long of the University of Minnesota School of Public Health and coauthors, released yesterday

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 put off efforts to address lowering health care costs in the 2006 legislation.

To obtain the 2010 data, the authors conducted a randomly sampled telephone survey of approximately 3,000 nonelderly adults in the state. With a 39 percent response rate, the sample included households with cell phones as well as landlines. The authors compared the 2010 data with previous annual surveys from 2006 through 2009.  The study is discussed in the Washington Post’s Wonk Blog, the National Journal, The Fiscal Times, and the Boston Globe.

Some other key findings:

  • More than two-thirds (68.0 percent) reported coverage through an employer, a significant increase (from 64.4 percent) over 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 percent of respondents said that their level of out-of-pocket health spending was at least 10 percent of their family income—a decline from 9.8 percent in 2006. The cost to employees of premiums, however, 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,” conclude Long and coauthors Karen Stockley and Heather Dahlen. “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.”