Mass. health law influences national policy

Speaker described how state law increased well-being and inspired a recent federal act

Senior Staff Writer
Wednesday, February 27, 2013

Health care reform in Massachusetts in 2006 influenced both the success and politics of the federal Patient Protection and Affordable Care Act passed in 2010, said Nancy Turnbull, senior lecturer in health policy at the Harvard School of Public Health, who helped former Governor Mitt Romney create the Massachusetts reform, in a lecture Tuesday. Turnbull’s talk, hosted by the Taubman Center for Public Policy and American Institutions, was intended to shed light on the ongoing health care debate in America and explore what lessons could be learned from Massachusetts.

The Affordable Care Act has provisions as the law in Massachusetts, including increased coverage for the poor, subsidies for people with middle income and a reformation of the insurance market. The act also requires offering an official comparison tool, like a website run by the Massachusetts state government, for different health insurance policies.

Turnbull outlined a number of lessons the national health care system could take away from Massachusetts’s experience. For instance, most Massachusetts residents polled said they liked the reform once it went into effect. The Massachusetts bill also improved access to and use of services, Turnbull said, adding that even cigarette smoking rates went down with the law’s passage. Racial discrepancies in health care access were also reduced, with a higher number of non-white people gaining health insurance coverage.

“(The Affordable Care Act) is an incremental law,” Turnbull said, adding that America would not be able to completely socialize health care — at least not for a long time.

Rhode Island has already implemented a few changes included in both the Massachusetts and national healthcare bills. For example, Rhode Island forbids insurance companies from turning people away due to preexisting conditions or charging higher premiums to the elderly.

Medicaid is well-utilized in Rhode Island, with approximately 75 percent of those eligible taking advantage of the program. Once the Affordable Care Act goes into effect, approximately 5 percent more people will qualify for Medicaid.

The law in Massachusetts brought the rate of those who were uninsured down from 8.1 percent in 2005 to 3.1 percent in 2011.

But one demographic remains hard to convince, Turnbull said: young men. Men between the ages of 18 and 26 have remained one of the least affected groups since the law passed.

Massachusetts adopted a number of strategies to get younger men to buy health insurance, including advertisements showing the cost of accidents for the uninsured — $3,000 for a broken arm, $11,000 for a broken leg — and gave out insurance information at Fenway Park in Boston.

“Costs remain a problem,” Turnbull said, adding that even a percentage of those who were eligible for free health insurance did not take advantage of the program. “These are the people I lay awake at night worrying about.”