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The Massachusetts experience

The National Bureau of Economic Research has published a paper by M.I.T. economics professor Jonathan Gruber summarizing the effect Massachusetts’s health reform law has had on the state. Gruber’s not a totally uninterested observer– he advised then Governor Mitt Romney and was a key architect of the state’s health reform plan. Still, he’s considered one of the country’s top health care economists, and he backs up all the points in his paper with citations and evidence. The Incidental Economist blog summarizes his findings:

  1. There has been a dramatic expansion of health insurance, reducing the uninsurance rate by 60-70%.
  2. No change in wait times for general and internal medicine practitioners have been observed.
  3. The share of the population with a usual source of care, receiving preventative care, and receiving dental care all rose.
  4. The rate of utilization of emergency care fell modestly.
  5. There has been a 40% decline in uncompensated care.
  6. The proportion of the population with employer-sponsored health insurance increased by 0.6%.
  7. The rate of employer offers of coverage grew from 70% to 76%.
  8. Mandate compliance has been very high: 98% compliance in reporting via tax filings of obtaining coverage or paying penalties.
  9. The administrative costs of health reform have been low. Overall implementation costs have been close to expectations.
  10. Premiums have fallen dramatically in the non-group market.
  11. Though group premiums have risen, they have not increased faster than one would expect from increases in other states in the region.
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