Dr. Adashi also reviews the appropriation challenges facing the law, such as defunding the spending authorizations in the ACA, or withholding money from the implementing agencies such as the Department of Health and Human Services. He states, "Whatever the strategy, defunding efforts are likely to force a showdown between Congress and the Administration, including the prospect of a partial government shutdown."
In "Medical Bankruptcy in Massachusetts: Has Health Reform Made a Difference?" investigators David U. Himmelstein, MD, and Steffie Woolhandler, MD, MPH, of the City University of New York School of Public Health, New York, NY, and Deborah Thorne, PhD, of Ohio University, Athens, Ohio, surveyed bankruptcy filers in Massachusetts in 2009, comparing them with similar subjects from 2007. They report that during this time period the share of all Massachusetts bankruptcies with a medical cause went from 59.3 percent to 52.9 percent, a statistically non-significant decrease of 6.4 percentage points. Because there was a sharp rise in total bankruptcies during that period, the actual number of medical bankruptcy filings in the state rose from 7,504 in 2007 to 10,093 in 2009.
Since Massachusetts was the first state to enact universal medical insurance, proponents had argued that such insurance would reduce the rate of medical bankruptcies. Although assigning medical factors as the primary cause of a particular bankruptcy is difficult, researchers found that there was no change in the rate of medical bankruptcies after enactment of the Massachusetts legislation.
"The recently enacted national health reform law closely mirrors Massachusetts' reform. That reform expanded the number of people with insurance but did little to upgrade existing coverage or reduce costs, leaving many of the insu
|Contact: Pamela Poppalardo|
Elsevier Health Sciences