Massachusetts Succeeds With Coverage, Struggles With Costs

Massachusetts has had ongoing success at maintaining near universal health insurance coverage following the state’s enactment of its comprehensive health reform law in 2006. Paying for health care continues to be troublesome, however. Those are the findings of the latest Massachusetts Health Reform Survey (MHRS), funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation.

Health insurance coverage. Massachusetts attained near universal coverage in the law’s second year and has maintained such coverage for seven years, according to the survey. More than 95 percent of adults in Massachusetts aged 19 to 64 had health insurance at the time of the survey, which was conducted in the fall of 2013. Employer-sponsored insurance (ESI) coverage was the main form of insurance in Massachusetts in 2013, covering 63.5 percent of adults.

Health care affordability. The ongoing issue of health care affordability continued to be a problem in Massachusetts in 2013. Among adults with family income below 500 percent of the federal poverty level (FPL), about one in five reported out-of-pocket health care spending at or above 5 percent of family income, and one in 10 reported spending at or above 10 percent of family income. About 40 percent reported that health care costs caused problems for them and their family in 2013 (42.8 percent in 2012 versus 40.8 percent in 2013).

“While Massachusetts has been successful at expanding and maintaining gains in health insurance coverage following the 2006 health care reform initiative, the evidence from 2013 suggests little progress so far at improving the affordability of health care for individuals since the passage of Chapter 224, the state’s cost-containment legislation. The findings for 2013, which are unchanged from those in 2012, suggest that, at best, any moderating of health care cost trends in Massachusetts has maintained and not improved affordability for individuals,” the study noted.

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