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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.
Massachusetts’ ambitious 2006 health reform initiative continues to be a proving ground for many of the elements being debated in national health reform proposals. Early evidence from Fall 2007 showed substantial gains in coverage under health reform in the state; however, those estimates predate the implementation of some important elements of Massachusetts’ initiative. Most notably, the penalty for failing to comply with the individual mandate, which requires that adults who have access to affordable coverage obtain insurance, was implemented in 2008 based on coverage as of December 31, 2007. The penalty in 2008 was relatively small, with a larger penalty taking effect in 2009 based on coverage for all of 2008.
Other important changes between 2007 and 2008 include increases in premiums and cost-sharing under CommCare (the new subsidized insurance program) and CommChoice (the new insurance purchasing arrangement), along with increases in the “affordability schedule” that determines the amount an individual is expected to be able to pay for health insurance under the individual mandate.
This policy brief provides an update of the impacts of health reform on insurance coverage in Massachusetts as of Fall 2008 for working-age adults, the primary target population of the state’s reform initiative. It also provides an update on support for health reform in the state. Estimates of the impacts of health reform on access to and affordability of health care in the state as of Fall 2008 are reported in a companion paper.
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