Health Reform Results
Data and reports on how well the law is achieving its goals of achieving nearly universal health insurance coverage and improving access to care for low-income and uninsured residents.
Key indicators of progress to-date
Health Reform in Massachusetts: An Update as of Fall 2010
This report is the latest in a series by the Urban Institute analyzing the impact of the Massachusetts health reform law. Findings show that despite the state's economic recession Massachusetts has maintained record low levels of uninsured and access to needed health care has improved. This report is based on the 2010 Massachusetts Health Reform Survey (MHRS), which has tracked the impact of the law annually since 2006. View a chartpack of the key findings here. (January 2011)
Health Reform in Massachusetts: Assessing the Results
Comprehensive slide deck of findings of surveys and other efforts to monitor the impact of the 2006 Massachusetts health reform law. Data from surveys and analyses by state government agencies including the Massachusetts Division of Health Care Finance and Policy, the Massachusetts Department of Revenue, and the Massachusetts Health Insurance Connector Authority as well as highlights from health reform tracking surveys conducted annually by the Urban Institute. Designed to support use of the charts in slide presentations and updated regularly. (October 2011)
Have working age people with disabilities shared in the gains of Massachusetts Health Reform?
Inquiry article by investigators from the University of Massachusetts Medical School examining the impact of Massachusetts health reform on working-age people with disabilities (abstract only). (November 2011)
Reasons Why Patients Remain Uninsured after Massachusetts’ Health Care Reform: A Survey of Patients at a Safety-Net Hospital
Journal of General Internal Medicine by researchers at Cambridge Health Alliance describing characteristics of uninsured patients seeking care in a safety net hospital and reasons for lacking insurance despite Massachusetts health reform. (September 2011)
Safety-Net Providers After Health Care Reform
Archives of Internal Medicine paper by Leighton Ku and colleagues showing increased demand for safety net health care providers despite the significant decrease in uninsured after Massachusetts health reform (abstract only). (August 2011)
Massachusetts’ Health Care Reform Increased Access to Care for Hispanics, But Disparities Remain
Health Affairs article by James Maxwell of John Snow, Inc. and others demonstrating increased health coverage and access for Hispanics after Massachusetts health reform, but both remain a challenge for Spanish-only speakers (abstract only). (August 2011)
MassHealth Enrollment Growth Since Reform
Analysis by MMPI examining the growth in MassHealth enrollment since passage of the state’s health reform law. This analysis shows that most of the growth in MassHealth enrollment (76 percent) has been in eligibility categories that existed prior to reform, and therefore would have occurred in the absence of the state’s health reform law. Click here to see a summary power point slide of the results. (May 2011)
Have Gender Gaps in Insurance Coverage and Access to Care Narrowed under Health Reform? Findings from Massachusetts
American Economic Review: Papers and Proceedings article by Sharon K. Long, Karen Stockley, and Shanna Shulman on gender gaps in insurance coverage and access under Massachusetts health reform. (May 2011)
‘RomneyCare’ Facts and Falsehoods
Factcheck.org article by Lori Robertson examining the Massachusetts health care reform law and popular claims by critics and supporters of the law. (March 2011)
Health Reform in Massachusetts: An Update
Article in the spring 2011 issue of the Boston Federal Reserve Bank’s Communities & Banking magazine on the results of the 2009 Massachusetts Health Reform Survey (MHRS). The MHRS is an annual survey that has been jointly funded by the BCBS of Massachusetts Foundation, the Robert Wood Johnson Foundation, and the Commonwealth Fund. (March 2011)
Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference?
The American Journal of Medicine article by David Himmelstein, Deborah Thorne and Steffie Woolhandler regarding the impact of Massachusetts health reform on medical bankruptcy. (March 2011)
Lack of Access Due to Health Costs Remains A Problem for Some in Massachusetts Despite the State's Health Reforms
Health Affairs article by researchers at the Brigham and Women's Hospital examining cost as a barrier to health care, particularly for low-income and vulnerable populations, despite Massachusetts' health reforms (abstract only). (February 2011)
The Importance of the Individual Mandate—Evidence from Massachusetts
New England Journal of Medicine article by Amitabh Chandra, Jonathan Gruber and Robin McKnight on the impact of the individual mandate on Massachusetts’ Commonwealth Care Program. (January 2011)
The Impacts of State Health Reform Initiatives on Adults in New York and Massachusetts
Health Services Research article by Sharon K. Long and Karen Stockley comparing health reform efforts in New York and Massachusetts. (January 2011)
Massachusetts Health Reform in 2008: Who are the Remaining Uninsured Adults?
State Health Access Reform Evaluation (SHARE) report by Sharon K. Long, Lokendra Phadera, and Victoria Lynch on the demographic, economic, social, and geographic characteristics of nonelderly uninsured Massachusetts residents, using the American Community Survey (ACS), funded through the Robert Wood Johnson Foundation. (August 2010)
The Importance of Young Adult Provisions in Massachusetts' Health Reform
State Health Access Reform Evaluation (SHARE) report by Sharon K. Long, Alshadye Yemane, and Karen Stockley on the effect of offering special Young Adult Plans exclusively through the Massachusetts Health Connector, funded through the Robert Wood Johnson Foundation. (August 2010)
Health Reform in Massachusetts: An Update as of Fall 2009
BCBS of Massachusetts Foundation report by Sharon K. Long and Karen Stockley of the Urban Institute, analyzing how the Massachusetts health reform law has affected coverage and access to care, based on the annual Massachusetts Health Reform Survey. View a visual presentation of the key findings here. (June 2010)
What Is the Evidence on Health Reform in Massachusetts?
Urban Institute policy brief by Sharon K. Long, examining the progress made in reaching the health reform law's primary goals and discussing lessons that may apply to national reform. (June 2010)
Sustaining Health Reform in a Recession: An Update on Massachusetts as of Fall 2009
Health Affairs article by Sharon K. Long and Karen Stockley based on the 2009 Massachusetts Health Reform Survey (abstract only). (June 2010)
Health Reform In Massachusetts Cut The Uninsurance Rate Among Children In Half
This study by Genevieve Kenney, Sharon Long, and Adela Luque found that after the implementation of health reform in Massachusetts, the uninsurance rate among children was cut in half. This was a result of increased enrollment of children in MassHealth and employer sponsored insurance. Massachusetts’ success provides an example for national health reform implementation of the strategies that worked to enroll children in health insurance plans (abstract only). (June 2010)
Massachusetts Health Reform: Impact on Women’s Health
Report by Tracey Hyams and Laura Cohen of the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital on women’s healthcare access, coverage and affordability after Massachusetts health reform. (June 2010)
The Impact of Health Care Reform on Hospital and Preventive Care: Evidence from Massachusetts
NBER White Paper by Jonathan Kolstad and Amanda Kowalski examines the impact of Massachusetts health reform on insurance coverage, utilization patterns and patient outcomes. (May 2010)
Another Look At The Impacts of Health Reform in Massachusetts: Using New Data and a Stronger Model
Using data from the Current Population Survey (CPS), Sharon Long, Karen Stockley, and Alshadye Yemane compare health care overage for adults before and after the implementation of Massachusetts health reform. The study also explores the impact on low-income adults below 300 percent of the poverty line and compares their experience to adults above 300 percent of poverty. (May 2009)
Urban Institute Studies Based on the Massachusetts Health Reform Survey
Four years of Urban Institute studies and Health Affairs articles based on the Massachusetts Health Reform Survey (MHRS), which was initiated in 2006 and conducted each fall, on topics such as: the impact of health reform on women; who uses emergency care and why; geographical and racial and ethnic differences in access and coverage; and how employees view the impact of reform on employer coverage. The MHRS has been jointly funded by the BCBS of Massachusetts Foundation, the Robert Wood Johnson Foundation, and the Commonwealth Fund.
Other assessments of Massachusetts health reform
Health Care in Massachusetts: Key Indicators – May 2011
Quarterly report by the Massachusetts Division of Health Care Finance and Policy that provides data on multiple aspects of Massachusetts health care coverage and delivery. View other Key Indicators reports here.
Testimonials from Beneficiaries of Health Reform
Two projects to document testimonials from consumers and patients enrolled in health programs created and/or expanded under the state's 2006 health reform law, one produced by the Massachusetts Health Connector and one produced by the Greater Boston Interfaith Organization through a BCBS of Massachusetts Foundation grant.
Consumers' Experience in Massachusetts
Kaiser Family Foundation report by Carol Pryor and Andrew Cohen of The Access Project on how Massachusetts health reform has affected consumers. (September 2009)
The Facts About Massachusetts Health Reform
Massachusetts Medical Society policy brief. (September 2010)
Overview of Massachusetts Health Care Reform
Presentation by Jon Kingsdale, former Executive Director of the Massachusetts Health Connector, at a January 2010 forum sponsored by the Robert Wood Johnson Foundation's State Coverage Initiatives program. View other presentations from this forum here.
Interim Report Cards on Massachusetts Health Care Reform
Pioneer Institute reports by Amy Lischko, Kristin Manzolillo, and Anand Gopalsami, assessing health reform based on criteria they developed to measure its progress. 1) Increasing Access, Jan. 2010 2) Equitable and Sustainable Financing, Feb. 2010 3) Administrative Efficiency, March 2010 4) Cost-Effective Quality, April 2010
After The Mandates: Massachusetts Employers Continue To Support Health Reform As More Firms Offer Coverage
Health Affairs article by Jon Gabel, Heidi Whitmore, Jeremy Pickreign, Will Sellheim, Shova KC, and Valerie Bassett on how employers responded to Massachusetts health reform, based on a 2008 survey of employers conducted after the individual mandate and employer “fair share” requirement took effect. (October 2008)
Report From Massachusetts: Employers Largely Support Health Care Reform, And Few Signs Of Crowd-Out Appear
Health Affairs article by Jon Gabel, Heidi Whitmore, and Jeremy Pickreign on how employers responded to early implementation of Massachusetts health reform, based on a 2007 survey of employers. (November 2007)
Lessons Learned to Date From The Massachusetts Healthcare Reform
Brief published for SEIU by Celia Wcislo, Malini Cadambi, and Yvonne Lui providing details on the passage of health reform and a comprehensive look at Chapter 58 and its implications. (August 2007)
Opinion polls on Massachusetts health reform
The Massachusetts Health Reform Law: Public Opinion and Perception: 2006
Report on the results of a September 2006 public opinion poll of Massachusetts residents on various aspects of the health reform law, prepared by researchers at the Harvard School of Public Health for the BCBS of Massachusetts Foundation. View a graphic presentation of the results here. (November 2006)
Massachusetts Health Reform Public Tracking Survey: 2007
Topline results from a May/June 2007 public opinion poll of Massachusetts residents on various aspects of Massachusetts health reform, prepared by researchers at the Harvard School of Public Health for the BCBS of Massachusetts Foundation. View a graphic presentation of the results here. (June 2007)
Massachusetts Health Reform Public Tracking Survey: 2008
Results from a June 2008 public opinion poll of Massachusetts residents on various aspects of Massachusetts health reform for the BCBS of Massachusetts Foundation. View a graphic presentation of the results here. (June 2008)
Massachusetts Health Reform: A Public Perspective From Debate Through Implementation
Health Affairs article by Robert Blendon, Tami Buhr, Tara Sussman, and John Benson, examining Massachusetts public opinion toward Massachusetts health reform from 2003 through 2008 (abstract only). (October 2008)
Physicians' Views of the Massachusetts Health Care Reform Law
New England Journal of Medicine article by researchers at the Harvard School of Public Health, the John F. Kennedy School of Government, and Social Science Research Solutions, based on a 2009 poll of Massachusetts physicians for the BCBS of Massachusetts Foundation and the RWJ Foundation. (October 2009)
Reports on key reform goals and issues
Data on the Individual Mandate: Tax Year 2009
Massachusetts Health Connector and Department of Revenue final report on the health insurance status of adult tax filers based on 2009 tax year data. View the Department of Revenue’s preliminary report here.
Primary Care in Massachusetts: An Overview of Trends and Opportunities
Massachusetts Division of Health Care Policy and Finance fact sheet on trends in the availability of primary care, 2006-2008. (July 2010)
Analysis of Individual Health Coverage in Massachusetts Before and After the July 1, 2007 Merger of the Small Group and Nongroup Insurance Markets
Massachusetts Division of Insurance report examining whether insurers experienced increased adverse selection as a result of the market merger that was part of Massachusetts health reform. (June 2010)
Enrollment and Disenrollment in MassHealth and Commonwealth Care
Massachusetts Medicaid Policy Institute report by Robert Seifert, Garrett Kirk, and Margaret Oakes, examining “churn” – the movement of enrollees in and out of public programs – and its effect on continuity of care. (April 2010)
Health of Massachusetts report
Massachusetts Department of Public Health website includes links to a comprehensive report that combines statistical information with policy perspectives from the field of public health, including assessments of the impact of Massachusetts health reform. (April 2010)
Short-Term Effects of Health Care Coverage Legislation: Massachusetts, 2008
U.S. Centers for Disease Control and Prevention (CDC) assessment of changes in population health indicators from pre- to post- Massachusetts health reform. (March 2010)
Results from the 2010 Massachusetts Employer Survey
Massachusetts Division of Health Care Finance and Policy report assessing the level of employer-sponsored health insurance in Massachusetts and how it relates to health reform. View other Employer Survey reports here.
Employer Fair Share Contribution: Filing Year 2010 Results and Analyses
Massachusetts Division of Health Care Finance and Policy presentation of data used to determine whether employers with 11 or more full-time-equivalent (FTE) employees made a "fair and reasonable" contribution toward the health costs of their workers. (September 2011)
Employers Who Had Fifty or More Employers Using MassHealth, Commonwealth Care, or the Health Safety Net
Massachusetts Division of Health Care Finance and Policy fact sheet on state spending in FY 2009 for individuals employed by firms where 50 or more employees receive health coverage through a publicly subsidized coverage program. (June 2010)
Network Adequacy in the Commonwealth Care Program
BCBS of Massachusetts Foundation report by Bailit Health Purchasing, on the adequacy of provider networks offered to Commonwealth Care enrollees by managed care organizations, including location, access, and cultural and linguistic competency. (April 2009)
Health Safety Net 2011 Quarter 2 Report
Massachusetts Division of Health Care Finance and Policy report on the Health Safety Net, which pays hospitals and community health centers for services provided to low-income residents who are otherwise ineligible for public health insurance programs. View other Health Safety Net reports here.
How is the Primary Care Safety Net Faring in Massachusetts?
Kaiser Family Foundation report by health researchers at George Washington University, on how the first two years of Massachusetts health reform affected the state's community health centers. (March 2009)
Low-Income Women’s Access to Contraception after Massachusetts Health Care Reform
Report from Ibis Reproductive Health and the Massachusetts Department of Public Health Family Planning Program, assessing health care reform’s impact on women’s access to contraception and reproductive health services. (September 2009)
In Debt But Not Indifferent: The Access Project's Medical Debt Resolution Program
Report by Andrew Cohen and Carol Pryor of The Access Project on the impact of Massachusetts health reform on medical debt, including issues related to health reform that left people vulnerable to unaffordable medical bills. (September 2008)
Stand Up and Be Counted: A Survey of Massachusetts Artists on Their Work Lives, Socioeconomic Status, Access to Healthcare, and Medical and Non-Medical Debt
Survey of Massachusetts artists measuring quality of life indicators and interactions with the state’s health reform law, conducted by the Artists Foundation and funded by an anonymous donor and the BCBS of Massachusetts Foundation. (February 2010)
"No One Asked Me": Latino's Experience With Massachusetts Health Care Reform
Dharma E. Cortes examines the experiences of low-income Latinos in Massachusetts after health reform. The results found that some individuals were intimidated by the health insurance enrollment process and turned to community based organizations for assistance. Also, study participants view of affordable premiums changed frequently as a result of changes to their financial situation. This report highlights the need for better communication strategies to assist diverse populations when implementing major health care access changes. (February 2010)