Early evidence of the impacts of health reform in Massachusetts

In 2006, Massachusetts enacted a major health care reform bill that seeks to move the state to (almost) universal coverage through a combination of Medicaid expansions, subsidized private health insurance coverage, insurance market reforms, and an individual mandate. This study examines the early impacts of those reform efforts using a pre-post evaluation based on survey data collected in Fall 2006 and Fall 2007. The surveys are based on stratified random samples, with oversamples of the low and moderate-income adults and uninsured adults who are the primary focus of Massachusetts's reform efforts. The study examines changes between 2006 and 2007 in insurance coverage, including continuity of coverage over time; access to and use of health care; and out-of-pocket health care costs and financial stress from health care spending. We estimate models for the overall adult population in Massachusetts, as well as for low- and moderate-income adults, controlling for individual, family, and community characteristics. These estimates provide early evidence of the impacts of the reform efforts in Massachusetts.