Massachusetts: Significant Subsidies, Physician Shortages

Posted by Grace-Marie Turner in Massachusetts on Jun 26th, 2009 | no responses

Tara Persico and I have a major new paper out this week (which we have been working on for months) entitled "Massachusetts' Health Reform Plan: Miracle or Muddle?"

It is so very important to study Massachusetts' efforts to achieve universal coverage because the state uses many of the same tools that Congress is considering to overhaul the nation's health sector. Massachusetts even had a head start with a low uninsured rate, broad bi-partisan support for the reform plan, and billions of dollars in subsidies from the federal government.

Well over half of those newly enrolled in health coverage in Massachusetts are in free or heavily subsidized plans, causing significant budget pressures for the state. Physician and medical workforce shortages have been exacerbated, with half of the state's internists and family physicians closing their practices to new patients. And rising costs for health insurance and health care continue to pose the biggest challenge to the success of the reform effort.

The state is facing growing opposition from businesses and individuals to the mandates. Citizens are also frustrated that they are required to have expensive health insurance but have difficulty finding physicians who will see them. Further, the promise has not been fulfilled that hospital costs would go down as fewer uninsured people have sought care in emergency rooms.

Among the Massachusetts reform initiatives that are being considered by Congress: an individual mandate, employer play-or-pay mandate, a national health insurance exchange, strict regulation of private health insurance, expansion of Medicaid, and a government-mandated health benefits package.

Before proceeding to implement this experiment on a nationwide scale, it would be wise to learn more about how the reform plan in this sophisticated, highly-motivated state is developing.