Abstract
Letters5 May 2015Changes in Mortality After Massachusetts Health Care ReformBenjamin D. Sommers, MD, PhD, Sharon K. Long, PhD, and Katherine Baicker, PhDBenjamin D. Sommers, MD, PhDFrom Harvard School of Public Health, Boston, Massachusetts, and The Urban Institute, Washington, DC.Search for more papers by this author, Sharon K. Long, PhDFrom Harvard School of Public Health, Boston, Massachusetts, and The Urban Institute, Washington, DC.Search for more papers by this author, and Katherine Baicker, PhDFrom Harvard School of Public Health, Boston, Massachusetts, and The Urban Institute, Washington, DC.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5085-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Kaestner's concerns. Testing the robustness of our findings by using alternative appropriate estimation techniques is a critical way to assess the reliability of our quasi-experimental approach.Because we lack sufficient detail on Dr. Kaestner's analysis, we cannot evaluate the soundness of his approach or the validity of his results. However, we believe that his concern about uneven cluster size driving spurious results is addressed by the state-level analysis presented in Appendix Table 4 of the Supplement, which the Supplemental Appendix describes in detail. We analyzed the study's 47 states by using annual state race-, age-, ...
Highlights
Massachusetts passed comprehensive health reform in 2006 with the goal of nearuniversal coverage
Changes were larger in counties with lower household incomes and higher pre-reform uninsured rates
The Massachusetts law had several components: a Medicaid expansion starting in July 2006 for adults; subsidized private plans for adults under 100% of the federal poverty level (FPL) in October 2006; and expanded coverage subsidies for adults up to 300% of FPL in January 2007
Summary
Massachusetts passed comprehensive health reform in 2006 with the goal of nearuniversal coverage. The law – which expanded Medicaid, offered subsidized private insurance, and created an individual mandate – was a model for the Affordable Care Act (ACA).[1] understanding the Massachusetts law’s impact has important policy implications. Previous research documents that Massachusetts’ reform succeeded in expanding health insurance among adults ages 19 to 64 by 3-8 percentage points.[1,2,3,4,5] Studies indicate improvements in access to care,[6,7,8] self-reported physical and mental health,[9] use of preventive services,[2,10] and functional status.[1,11] there has been no evidence on the law’s effect on mortality. Massachusetts’ 2006 health reform has been called a model for the Affordable Care Act. The law attained near-universal insurance coverage and increased access to care.
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