Democrats may have overstimated public enthusiasm for health care reform following passage of the Affordable Care Act in March (and underestimated the willingness of the opposition to move public opinion against the law). But they still believe that Americans will support reform once they begin receiving benefits in 2014. The first survey of consumers who receive subsidized health insurance in Massachusetts, which served as a model for national reform, suggest there is reason to be hopeful:
Eighty-six percent of those surveyed said they were pleased with the range of services covered and the quality of care available, while 82 percent had similar feelings about the choice of doctors.
The majority of patients — 81 percent — reported they had seen a doctor for regular care at least once since receiving coverage through the Commonwealth Care program, which is the state-subsidized health insurance program created for low- and moderate income residents under Massachusetts’ 2006 health care law.
The survey also found that some members did report experiencing challenges in scheduling doctor’s visits.
The state exchanges — or the new marketplaces for insurance — that will allow individuals and families to purchase comprehensive basic coverage will differ structurally from state to state, but these results may push more governors to consider the Massachusetts design. Federal regulators can also use the state’s high degree of satisfaction with the “range of services” to make some decisions about how best to structure a essential benefits package, which is widely seen as one of the biggest challenges in reform implementation.
During an Institutes of Medicine meeting in January, John Kingsdale — the former director of the Massachusetts Connector Authority — (Massachusetts’ version of the exchange) warned regulators against “overreaching” in detailing which benefits insurers will have to provide. “My experience suggests revisiting and learning from cases and some flexibility and even phasing in would all be very helpful as you go down the path of defining a minimum benefit that will be extremely controversial,” he said.