New Massachusetts Report Vindicates Proponents Of Shared Responsibility

Since Massachusetts enacted comprehensive health care reform in 2006, early data has indicated that reform has successfully reduced the number of uninsured and increased access to coverage. The Massachusetts legislation did not address cost containment, but the popular reform has vindicated proponents of an employer mandate and shared responsibility.

Early analysis of the Massachusetts experience confirms that “firms in Massachusetts have not dropped coverage, restricted eligibility, changed the scope of benefits, limited the range of provider choices, nor undermined the quality of care available under their plans,” and a new report released today reveals that “the spending for expansion has been shared more or less in proportion to how the spending for coverage was distributed prior to reform.”

In other words, while costs increased — as they have nationally — employers, consumers and state government paid the same, proportionately, for health coverage after 2006 as they did the year before the initiative started:


The government contributions, the report notes, “have grown slightly faster than the other two groups largely because of the introduction of a new public program.” “Government payments for uncovered services, however declined sharply. The combined effect was that government’s share of total payments was similar to its share prior to reform.”

From 2005 to 2007, “health insurance premiums rose by 16 percent in Massachusetts,” and overall health care spending increased by $4.7 billion. While an increase in take-up of coverage contributed to the spike, the rise is mainly the result of higher medical costs. In fact, the report concludes that “spending on coverage would have increased by about 60 percent of the $4.7 billion between 2005 and 2007 even if the number of people with insurance had not grown at all because of increases in premiums and per capita health care costs.”

Thus, what conservatives describe as a “government-take over” of health care is actually an arrangement in which all of the different players are helping to finance the system. Half of the newly-insured “are enrolled in private health insurance and employer-sponsored plans” and “the number of businesses offering coverage increased while the number reporting that the reforms are a financial burden fell to 29 percent.” Still, any sustainable health reform must address skyrocketing health care costs, and a health conscious Congress must learn from the victories and difficulties of the Massachusetts example.