Health Status and Use of Preventive Services Improved After Enactment of Massachusetts’ Health Care Reform Law

The 2006 introduction of health care reform in Massachusetts was associated with improved health and greater use of preventive services. (Image: cudazi/iStock.com)

The 2006 introduction of health care reform in Massachusetts was associated with improved health and greater use of preventive services. (Image: cudazi/iStock.com)

Implementation of Massachusetts’ 2006 health care reform law, the model for the federal Affordable Care Act, was associated with improved health and greater use of preventive services relative to other New England states. The finding appears today in The Milbank Quarterly.

Massachusetts’ health care reform law included an individual mandate to obtain health insurance, expanded Medicaid coverage for children and long-term unemployed adults, and subsidized health insurance for low- and middle-income residents. It also created a health insurance exchange for higher-income residents to obtain unsubsidized insurance.

In the Milbank study, researchers sampled 345 211 adult New Englanders aged 18 to 64 years who participated in the Behavioral Risk Factor Surveillance System from 2001 to 2011 to compare their self-reported health status and use of preventive services. The researchers found that after the 2006 implementation of the health care reform law, Massachusetts residents reported greater improvements in their general health (1.7%), physical health (1.3%), and mental health (1.5%) than did residents of other New England states. Massachusetts residents also reported relative increases in rates of Pap screening (2.3%), colonoscopy (5.5%), and cholesterol testing (1.4%). The greatest gains in health status were found among those whose households earned only up to 300% of the federal poverty level. The relative gains in health status for Massachusetts residents were comparable among whites, blacks, and Hispanics, suggesting that any existing health care disparities among these groups were unchanged by the reform law.

“Our results demonstrate the potential benefits of health care reform in Massachusetts that may also be achieved through the implementation of the federal Affordable Care Act,” said John Z Ayanian, MD, MPP, formerly of Harvard Medical School and now director of the University of Michigan Institute for Healthcare Policy and Innovation, in a release.

Agreeing is Howard Markel, MD, PhD, editor of The Milbank Quarterly and professor of the history of medicine at Michigan. “In an era of demagoguery and exaggeration posing as ‘facts,’ it is essential to collect and analyze solid evidence on our nation’s health care policies,” said Markel, who is also a contributing writer at JAMA, in the release. “Indeed, it is the only way I know to approach the Sisyphean task of reforming and improving health care access for all Americans.”



Categories: Caring for the Uninsured and Underinsured, Health Policy, Public Health

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