National reform: what can we learn from evaluations of Massachusetts? National reform: what can we learn from evaluations of Massachusetts?

Collection: Health Policy and Services Research Contributor(s): Long, Sharon K. Stockley, Karen. Dahlen, Heather. Robert Wood Johnson Foundation. State Health Access Data Assistance Center, University of Minnesota. State Health Reform Assistance Network. Publication: [Minneapolis, Minn.] : State Health Access Data Assistance Center, [2011] Language(s): English Format: Text Subject(s): Health Care Reform Insurance Coverage -- economics Insurance, Health -- economics Massachusetts United States United States. Genre(s): Technical Report Abstract: The 2010 Patient Protection and Affordable Care Act (ACA) is modeled on Massachusetts' 2006 landmark reform--An Act Providing Access to Affordable, Quality, Accountable Health Care. As in Massachusetts, national reform includes public program expansions; the creation of health insurance exchanges; premium and cost-sharing subsidies; an individual mandate; and requirements for employers, among other provisions (Henry J. Kaiser Family Foundation, 2010). This brief provides a synthesis of what we know about the impacts of Massachusetts' health reform and an assessment of what these findings mean for the ACA and for the evaluation of the ACA's impacts. KEY FINDINGS. Impact of Massachusetts' Reform on Non-Elderly Adults. (1) There have been strong gains in insurance coverage for non-elderly adults under health reform. (2) Over time, uninsurance in Massachusetts has been consistently much lower than in the nation broadly. (3) There is no evidence that the expansion of public coverage has led to the crowd-out of employer-sponsored coverage. (4) There is evidence of gains in access to and use of care in under reform, although not across all measures. (5) There have been improvements in the affordability of care, particularly as measured by the share of adults forgoing care due to costs, although these improvements have tended to erode over time. Copyright: Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information) Illustrations: Illustrations NLM Unique ID: 101593035 (See catalog record) Permanent Link: http://resource.nlm.nih.gov/101593035