What does the Massachusetts experience tell us about the potential impact of the affordable care act on the use of clinical preventive services?

Background: Expansion of health insurance coverage for clinical preventive services provides an opportunity for improvements in the health of adults. There is limited research on how much expansion of health insurance coverage may affect clinical preventive service use.

Objective: To examine potential effects of the 2006 health reform in Massachusetts on clinical preventive service use.

Methods: We used data from the Behavioral Risk Factor Surveillance System to examine change in healthcare access and use of clinical preventive services among working-aged adults pre-reform (2002-2005) and post-reform (2007-2010) in Massachusetts compared with change in other New England states. Results: In Massachusetts, the proportions of adults who had health insurance coverage, a healthcare provider, no cost barrier to healthcare, an annual routine checkup, and a colorectal cancer screening increased significantly more than those in the other New England states. Massachusetts did not show the significant decline in cervical cancer screening observed in the other New England states. Cholesterol screening, adult influenza immunizations, and mammography screening did not improve more in Massachusetts than in other New England states.

Conclusions: The Affordable Care Act may increase healthcare access and improve use of clinical preventive services. However, the effects of the Affordable Care Act on clinical preventive service use may vary by the type of service and by state.