Massachusetts Health Disparities: Key Lessons for the Nation

Abstract

In September, 2010 the US Census Bureau announced the number of uninsured persons in the USA had risen to the highest ever recorded at 50.7 million. How much of a dent the Patient Protection and Affordable Care Act (Pub. L. 111-148, PPACA, commonly known as national health insurance reform) will make on this crisis remains an ongoing question. While modeling estimates suggest that up to 32 million may gain coverage, many look to the Massachusetts health reform efforts begun in 2006 as a more real world experience of what may actually happen at the national level. Similarities between both plans include Medicaid expansions, subsidies for low income persons to obtain private coverage, business tax credits, individual and business mandates. Analyses using distinct datasets have shown that after the Massachusetts law was enacted, coverage in the state increased by approximately six percentage points.1 However, these are unadjusted pre-post comparisons. How of much of that change can be specifically attributed to the legislation has remained unclear.