Navigation Links
Uninsured patients in Mass. still mainly the working poor, despite state's health reform
Date:9/19/2011

Despite the implementation of the Massachusetts health care reform designed to bolster employer-based insurance and to provide no-cost or low-cost insurance to those unable to afford it, the uninsured in Massachusetts remain predominantly the working poor, according to a new study by researchers at Harvard Medical School just published online in the Journal of General Internal Medicine.

The 2006 comprehensive health care reform was designed to achieve "universal coverage" through new laws requiring that employers with more than 10 employees offer insurance and that all state residents obtain insurance or pay a fine. It also provided free or low-cost, subsidized insurance to state residents with low incomes.

Yet, most estimates put the number of uninsured in the state at well above a quarter million. For instance, last week the Census Bureau released its survey which found 370,000 people to be uninsured in Massachusetts -- 5.6 percent of the state's population.

To understand why people remained uninsured after the reform, the study authors surveyed 431 patients, ages 18-64, who were visiting the emergency room of Massachusetts' second largest safety-net hospital.

The researchers found that of the 189 patients without health insurance, two-thirds (65.9 percent) were employed, but only a quarter had access to employer-sponsored insurance. In addition, about one-third (35.2 percent) of uninsured patients reported having lost previous insurance coverage, with the majority of these (51.9 percent) having lost their coverage due to loss of a job or transition from one job to another.

"These findings illustrate that tying insurance to employment can be an unstable mechanism for providing coverage," said the study's lead author, Dr. Rachel Nardin, a neurologist at Cambridge Health Alliance. "We found that employer-based coverage failed the self-employed; those who worked for firms that did not offer insurance, especially small firms exempt from a requirement to offer insurance; and the poor who could not afford employer-sponsored insurance even when it was offered to them. The system of coverage also failed those who lost their job, which is particularly problematic with the current economic downturn."

More than 85 percent of the uninsured patients interviewed had incomes low enough to qualify them for free or low-cost, state-subsidized private insurance. Nonetheless, one-third reported being uninsured because they could not find affordable insurance.

In fact, although the majority of the uninsured were aware of the new legal requirement that they carry health insurance, nearly half reported that it motivated them to try to find insurance but that they had been unable to find insurance they could afford.

Senior author Dr. Danny McCormick, an internist at Cambridge Health Alliance, said: "It appears that for people with very low incomes, even state plans with subsidized insurance premiums may be too costly. Also, under the reform law workers who are offered employer sponsored insurance but decline it due to cost are not eligible for state subsidized insurance, no matter how poor they are."

McCormick added, "If we are serious about the goal of universal coverage, we will need to further reduce or eliminate the financial barriers to getting insurance that still clearly exist in Massachusetts."

The study also found that another common reason for losing previously held insurance was having had it cancelled without notice or because of lapsed paperwork. Only 5.6 percent of the interviewees were uninsured because they didn't think they needed insurance, suggesting there were few seeking a so-called free ride.

"Our study shows the many ways that patients can get left out of a complex system for providing health insurance," said McCormick. "While the reform substantially reduced the number of uninsured in our state, it failed to fully reach the demographic groups it targeted. Our findings emphasize the fragility of a reform requiring voluntary uptake, periodic renewal, dependence on employment and cost-sharing."

The study authors also point out that the Massachusetts health care reform law served as the model for the national health reform law, the Affordable Care Act, and thus may suggest even larger difficulty ahead for national health reform.

Nardin commented: "In Massachusetts, we had about 10 percent uninsured before the reform. In many other states, the uninsured rate is in the 20-25 percent range. If our results are any indicator, the national reform may leave many working poor uncovered.

"Although arguments about political feasibility are a major challenge, our study suggests that a comprehensive reform guaranteeing coverage to all residents without eligibility restrictions such as that provided by many single-payer systems would be a more effective way to achieve universal coverage than the Massachusetts reform."


'/>"/>

Contact: Mark Almberg
mark@pnhp.org
312-782-6006
Physicians for a National Health Program
Source:Eurekalert

Related medicine news :

1. Health Care Reform Report Covers Uninsured, Reduces Costs
2. Free Health Care for the Uninsured Is Coming to Atlanta This Month
3. Consumer Health Insurance Site Founder: Health Reform or No Health Reform, Americans Can Help Reduce Rolls of the Uninsured
4. NJHA: Charity Care Must Be a Priority as Uninsured Burden Grows
5. Finding Good Migraine Care a Headache for the Uninsured
6. Uninsured get poor care for migraine: Harvard study
7. CA Dental Hygienists' Association to Provide Care to Thousands of Uninsured at Southland's Largest Free Public Health Clinic
8. Uninsured Americans have 50 percent higher odds of dying in hospital from heart attack or stroke
9. Uninsured more likely to die from trauma than patients with insurance, study finds
10. Free Clinics Play Important Role for Uninsured in U.S.
11. Number of Uninsured Jumped By Nearly 3 Million in 2009
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/6/2016)... ... , ... The joy associated with Mother’s Day is mixed with worry and fear for new ... across the country. For the first time ever, the March of Dimes and ... their Mother’s Day beside a crib surrounded by lifesaving equipment or peering through a glass ...
(Date:5/6/2016)... FL (PRWEB) , ... May 06, 2016 , ... ... will feature AsedaSciences® in an upcoming episode, airing third quarter 2016, via Discovery ... the vision of becoming a leader in optimized drug discovery through innovative cellular ...
(Date:5/6/2016)... ... 06, 2016 , ... From the Speaker Podium to the Exhibit Floor at ... insights on managing Customers Engagement at SpeechTek 2016 Event, taking place May 23-25 at ... a Presentation on “5 Customer Engagement Strategies to improve Customer Satisfaction in ...
(Date:5/6/2016)... ... 06, 2016 , ... Yisrayl Hawkins, Pastor and Overseer at The House of Yahweh, has written ... found in the Bible about helping to stop cancer. Yisrayl says there are too many ... that the health and science industries will pay close attention and take action. The Pastor ...
(Date:5/6/2016)... ... May 06, 2016 , ... “ Crossing Over: Affirmations of ... of dying patients who have allowed those holding vigil to glimpse into the supernatural ... CHPN, hopes to help readers spiritually and practically gain insight into providing care to ...
Breaking Medicine News(10 mins):
(Date:5/4/2016)... DUBLIN , May 4, 2016 /PRNewswire/ ... the addition of the  "Global Acute Ischemic ... 2016"  report to their offering.  ... Global Acute Ischemic Stroke Market ... insights into Acute Ischemic Stroke pipeline products, ...
(Date:5/4/2016)... 4, 2016 Research ... "Global Actinic Keratosis Market and Competitive Landscape ...      (Logo: http://photos.prnewswire.com/prnh/20160330/349511LOGO ... Competitive Landscape Highlights 2016, provides comprehensive insights ... epidemiology, Actinic Keratosis market valuations and forecast, ...
(Date:5/3/2016)... , May 4, 2016 ... across 154 pages, profiling 09 key companies and ... a professional and in-depth study on the current ... basic overview of the industry including definitions, classifications, ... market analysis is provided for the international market ...
Breaking Medicine Technology: