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Who Gained the Most Under Health Reform in Massachusetts: Massachusetts Health Reform Survey

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Although Massachusetts enacted health care reform with a mandate for health insurance coverage for individuals, questions remain as to the adequacy of coverage for the state’s population.
This policy brief examined the impact of health reform on coverage for population groups, such as those based on age, race/ethnicity, employment and geography, in Massachusetts. Adults between 18 and 64 years of age were interviewed in fall 2006, before health reform implementation, and in fall 2007, after reform initiation. Multivariate regression models controlled for differences between the samples interviewed.
Key Findings:
* By fall 2007, uninsurance significantly decreased across all groups. Younger adults saw a large decrease in uninsurance of almost 11 percent. Groups that previously had high rates of uninsurance also saw large decreases in uninsurance such as Hispanic adults that saw uninsurance decrease by 11 percent.
* For working adults, uninsurance dropped by 10 percent for those employed in small firms and by 15 percent for workers without offers of employer-sponsored insurance (ESI).
* As compared to the insured, the uninsured in fall 2007 were more likely to be from groups that were typically hard to cover such as younger adults, males and the unemployed.
Although reform saw decreases in uninsurance for a range of population groups, it will be necessary to increase coverage to subgroups that have a history of being hard to cover in order to attain universal coverage in Massachusetts.