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, especiall
|Contact: Mark Almberg|
Physicians for a National Health Program