News & Events

Mass-Care Releases Comprehensive New Report on Mass. Health Reform

Mass-Care, an alliance of organizations that support single payer health care reform, and Massachusetts Physicians for a National Health Plan today released a comprehensive new report on the outcomes of the Massachusetts Health Reform law, as well as analysis of 5 years of media coverage of the law.

While the Massachusetts health reform law of 2006, widely regarded as the model for the new federal health law, reduced the uninsured population in the state, it did so at the cost of rapidly rising underinsurance, increased health care premiums, and a financial crisis among the state’s safety-net hospitals and community health centers. And the financial burden of the reform has fallen disproportionately on lower-middle-class families.

The results will surprise many: while Massachusetts reform has had some important beneficial impacts, covering about half of the uninsured and modestly improving access to care, these gains have come at a price:

  • Claims that health reform was a "shared responsibility" are disingenuous: rising costs after health reform have been disproportionately shouldered by lower-middle class families, letting the wealthy off the hook.
  • Small businesses have been particularly hard hit by health reform: quality health care coverage for small business employees all but disappeared in the years following health reform, and reform led to premiums for small employers rising more rapidly than in other states (7 percent faster for individuals and 14 percent faster for families).
  • Health reform accelerated the growth of administration in the Massachusetts health care system, by adding additional complexity to an already expensive and fragmented system.
  • Underinsurance has increased rapidly after health reform, with high-deductible plans tripling between 2006 and 2008.
  • Health reform and subsequent policy decisions have led to a financial crisis for the state’s safety net hospitals and health clinics, which provide care for low-income and minority communities, despite growing demand for safety net care.

Most of the newly insured previously had access to the state’s safety net program for the uninsured (called the Free Care Pool), and certain income groups actually had better access to care when they were uninsured than under Commonwealth Care coverage. Although Massachusetts reform was largely paid for by federal taxpayers, the remaining costs were still high and unsustainable for the state, which has led the state to gradually roll back the Commonwealth Care program (by disenrolled thousands of documented immigrants, increasing the share beneficiaries who are forced to pay premiums, raising co-payments, imposing limited networks, and other strategies that shift costs on to low-income families). Furthermore, the state has regularly increased the share of income it claims residents can afford to spend on health care premiums, in an attempt to continue mandating people to purchase insurance.

Lastly, the report uncovered a pattern of widespread media bias in coverage of the Massachusetts health reform law. Most media sources cite only the lowest estimates of the uninsured in Massachusetts, although these have been demonstrated as inaccurate. It is also common for the media to perpetuate inaccurate myths about uninsured residents’ use of emergency rooms, and to project savings from health reform that never materialized: even as half of the uninsured gained some form of insurance coverage, emergency room use and preventable or avoidable emergency room use continued to rise. Health reform has also failed to significantly reduce the share of families facing medical debt or facing health-related bankruptcy.

You can download the report in its entirety here: