MINNEAPOLIS. June 5, 2008—In the first year since Massachusetts implemented mandatory health insurance coverage for everyone, the uninsurance rate among adults in the state dropped by almost half, according to a new Urban Institute study published today on the Health Affairs website. 

The Massachusetts law features an “individual mandate” that requires state residents to purchase “creditable” health insurance if “affordable” coverage is available.

The rate of uninsured adults fell from 13 percent to 7.1 percent.

The study also shows that access to care for low-income Massachusetts adults has increased, and the share of adults with high out-of-pocket health care costs and problems paying medical bills has dropped.

The report has implications for the campaign to require universal health care insurance in Minnesota, which has long been part of the Minnesota Medical Asssociation's vision for health care reform, Physicians' Plan for a Healthy Minnesota.

In May Governor Pawlenty signed into law a health care reform bill that will bring Minnesota closer to the goal of universal coverage, extending coverage to an estimated 12,000 more Minnesotans.

Study author Sharon Long, a principal research associate at the Urban Institute, found no evidence that the Bay State’s expansion of publicly subsidized coverage has “crowded out” employer-sponsored coverage.

Long’s findings are based on two rounds of telephone interviews with randomly selected Massachusetts adults (ages 18-64), in fall 2006 -- just prior to implementation of key elements of the state’s reforms -- and fall 2007.

In addition to the individual mandate, the Massachusetts reforms included:

• an expansion of the Massachusetts Medicaid program, MassHealth;
• the creation of new income-related state subsidies for the purchase of health insurance, Commonwealth Care;
• the creation of a new purchasing arrangement for private health insurance, Commonwealth Choice, via the Commonwealth Connector;
• a requirement that employers with more than 10 workers either contribute to their employees’ coverage or pay into a state fund;
• and a consolidation of the individual and small-group private insurance markets.

Long’s study is one of two articles on the Massachusetts experience appearing today on the Health Affairs Web site. In the other paper, John McDonough and coauthors chart the progress of the reforms and the challenges that remain. McDonough is a senior adviser to Sen. Edward Kennedy (D-MA) on national health reform.

Health Affairs report