• The Massachusetts health reform experience, in three charts

    You may have already heard quite a lot about consequences of the Massachusetts’ health reform. But, have you seen it all in charts? Now you can, in my new post on the LDI site.


    • In the referenced blog post you say that in Massachusetts

      “…coverage increased across all categories including employer-sponsored coverage. Employers were more likely to offer coverage after reform than before. Under reform, employers are more likely to offer health insurance coverage to their workers, with the share of employers offering coverage up from 70% in 2005 to 77% in 2010.”

      Although the last two sentences are apparently true (more employers were offering insurance supposedly to avoid the penalty), take up rates were down significantly according to Figure 5 of what I believe to be the most recent Health Insurance Survey report released by the State of Massachusetts (released in January 2013 but covering 2006-2011), ESI is down from a high of 67% to just under 62% of Massachusetts’ population. Perhaps you have newer data

    • The implementation of Commonwealth Care for <300% FPL is a step in the right direction, reducing OOP costs for lower income groups. Provision of first dollar coverage (without a deductible) and lower maximum copays(and services) on prescription drugs are much better than the ACA.

      The cost per capita appears to be ~ $4300. Much better than under the ACA, due to management and cost-reduction savings.

      I can't comment on the quality of care of the Commonwealth Care providers, however I will presume that it is good.

      This is in a sense a public option with cost controls which the ACA does not have and is open to a much broader income range than the ACA.

      The data you present is lumped, so it is hard to say what the actual subgroups pay as a portion of income and thus it is improper to compare directly for this reason as well.

      The ACA requires much more contribution and is adjustable based on the insurers meeting their AV. The problem that many in the top 10% don't understand is that thousands of dollars for OOP costs in the low income bracket is untenable and that which cannot be paid won't be paid.

      As for Gruber, I talked with him at a Bear Stearns conference prior to their demise. He reminded me of Robert McNamara, attempting to calculate just how much war the U.S. could afford.

      How much more can lower income groups spend on healthcare, nothing. Unless the healthcare strategy is to get more obesity, diabetes and cardiac disease by encouraging substitution of calories with even more cheap soda, candy bars and fast food. But chained-CPI is yet another topic, for another blog.