View Research by Author - Sharon K. Long

More about Sharon K. Long's areas of expertise can be found on this Urban Institute expert's page.

Citation URL: http://www.urban.org/SharonKLong

Massachusetts residents are frequent users of emergency department (ED) care, with high levels of use continuing despite significant improvements in access to care as a result of the state’s 2006 health reform initiative. In an effort to better understand ED use in Massachusetts, this policy brief looks at ED use among working-age adults, focusing on reported reasons for using the ED and barriers to obtaining needed health care among ED users. Findings show adult ED users in Massachusetts are a sicker, more disabled, and more chronically ill population and report more difficulties obtaining care in the community and more unmet need for care than other adults in the state. Potential strategies for addressing preventable ED use include efforts targeted to specific care settings and particular population groups.

Massachusetts, which enacted a landmark health care reform bill in April 2006, is now beginning the fourth year of its ambitious health reform initiative, with evidence of strong and continuing gains in insurance coverage. This policy brief, which is based on the 2009 Massachusetts Health Insurance Survey (HIS), shows uninsurance in Massachusetts continuing at historically low levels—at 2.7% for the overall population, 1.9% for children and 3.5% for non-elderly adults. The findings suggest that the recession had had limited impact on health insurance coverage as of spring of 2009.

The Urban Institute, along with its subcontractor, Social Science Research Solutions, conduct the Massachusetts Health Insurance Survey (HIS) for the Massachusetts Division of Health Care Finance and Policy to obtain information on health insurance coverage and access to and use of health care for the non-institutionalized population in Massachusetts. This report summarizes the results of the survey for health insurance coverage in 2008 and 2009, including the finding that more than 97 percent of Massachusetts residents have health insurance in 2009, despite the economic recession.

The national health reform debate continues to draw on Massachusetts' 2006 reform initiative, with a focus on sustaining employer-sponsored insurance. This study provides an update on employers' responses under health reform in fall 2008, using data from surveys of working-age adults. Results show that concerns about employers' dropping coverage or scaling back benefits under health reform have not been realized. Access to employer coverage has increased, as has the scope and quality of their coverage as assessed by workers. However, premiums and out-of-pocket costs have become more of an issue for employees in small firms.

Massachusetts began an ambitious push toward near universal health insurance coverage in 2006. This policy brief provides an update of the impacts of health reform in Massachusetts on insurance coverage as of Fall 2008 for working-age adults, the primary target population of the reform initiative, along with an update on support for health reform in the state. Findings demonstrate that the state has achieved its goal of near universal health insurance coverage and that state residents continue to show strong support for health reform, even in the face of increasing program costs and the recession that began in December 2007. Given the success of the coverage expansion, Massachusetts policymakers are turning to the next phase of health reform - reigning in health care costs.

Urban Institute researcher Sharon Long answers five questions about Massachusetts's landmark health reform experiment, which aims for near-universal coverage and improved access to affordable health care. In 2006, lawmakers passed a bill that required most adults to get health insurance, expanded Medicaid, provided subsidies for lower-income adults, created a health insurance exchange where residents can buy plans easily, and required employers to offer coverage or pay a fee. Early success has made the state a model for nationwide reform.

Massachusetts continues to move forward on comprehensive health reform. Uninsurance is at historically low levels, despite the recent economic downturn. Building on that coverage expansion, there have been improvements in access to care and the affordability of care in the commonwealth. Notwithstanding these successes, some of the early gains under health reform in reducing barriers to care and improving the affordability of care had eroded by Fall 2008, reflecting trends that predate health reform in Massachusetts-constraints on provider capacity and increasing health care costs. Because these are national concerns as well, Massachusetts continues to offer lessons for national health reform efforts.

Massachusetts continues to move forward on comprehensive health reform, with improvements in coverage, access to care and the affordability of care in the state. This policy brief provides a supplement to a recent Health Affairs article on health reform in Massachusetts, examining geographic and racial/ethnic differences in access to care and affordability of care across the commonwealth in Fall 2008.

The Urban Institute, along with its subcontractor, International Communications Research, conducted the 2008 Massachusetts Health Insurance Survey (HIS) for the Massachusetts Division of Health Care Finance and Policy to obtain information on health insurance coverage and access to and use of health care for the non-institutionalized population in Massachusetts. This report provides information about the methods used to collect and analyze the 2008 HIS data.

The Urban Institute, along with its subcontractor, International Communications Research, conducted the 2008 Massachusetts Health Insurance Survey (HIS) for the Massachusetts Division of Health Care Finance and Policy to obtain information on health insurance coverage and access to and use of health care for the non-institutionalized population in Massachusetts. This report summarizes the results of that new survey, including the finding that more than more than 97 percent of Massachusetts residents have health insurance, with only 2.6 percent of state residents remaining uninsured.

Return to list of authors