Document Detail


The accountable health care act of massachusetts: mixed results for an experiment in universal health care coverage.
MedLine Citation:
PMID:  23025869     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The affordable health care act of Massachusetts, signed into law in 2006, resulted in 98% of Massachusetts residents' having some form of insurance coverage by 2011, the highest coverage rate for residents of any state in the nation. With a strong economy, a low unemployment rate, a robust health care delivery system, an extremely low number of undocumented immigrants, and a low baseline uninsured rate, Massachusetts was well positioned for such an effort. Ingredients included mandates, the creation of separate insurance vehicles directed to both poverty-level and non-poverty-level residents, and the reallocation of the former free care pool. The mandates included consumer mandates and employer mandates; the consumer mandate applies to all Massachusetts residents at the risk of losing personal state tax exemptions, and the employer mandate applies to all Massachusetts businesses with 10 or more employees at the risk of per employee financial penalties. The insurance vehicles were created with premiums allocated on the basis of ability to pay by income classes. Unexpected effects included escalating taxpayer health care costs, with taxpayers shouldering the burden for the newly insured, continuing escalating health care costs at a rate greater than the national average, overburdening primary caregivers as newly insured sought new primary care gatekeepers in a system with primary caregiver shortages, and deprivation of support to the safety-net hospitals as a result of siphoned commonwealth free care pool funds. This exercise demonstrates specific benefits and shortfalls of the Massachusetts health care reform experiment, given the conditions and circumstances found in Massachusetts at the time of implementation.
Authors:
Alexander Norbash; David Hindson; Janelle Heineke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Radiology : JACR     Volume:  9     ISSN:  1558-349X     ISO Abbreviation:  J Am Coll Radiol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101190326     Medline TA:  J Am Coll Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  734-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Boston University School of Medicine, Boston, Massachusetts. Electronic address: norbash@bu.edu.
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