Health Reform Works—Just Look at Massachusetts
There was a 'significant decline in deaths' after health reform in the Commonwealth, according to a new study.
Harvard School of Public Health researchers estimate that Massachusettsâ€™ health reform law, which provided near-universal coverage beginning in 2006, has prevented approximately 320 deaths per yearâ€”one life saved for each 830 people gaining insurance, according to a new study published in Annals of Internal Medicine.
The study reports that inÂ the first four years after Massachusetts instituted comprehensive health reform,Â mortality in the state decreased by 2.9 percent compared with similar populations in states that didnâ€™t expand health coverage. This news is big enough for Time magazine to publishÂ the followingÂ headline:Â “Obamacare Works, Massachusetts Proves It.”
The study looks at whether or notÂ health insurance expansion can save lives,Â and it appears that answer is yes.
â€śGiven that Massachusettsâ€™ health reform was in many ways the model for the Affordable Care Act, it is critical to understand the lawâ€™s potential implications for population health,â€ť said Benjamin Sommers, assistant professor of health policy and economics at HSPH and lead author of the study. â€śWhat we found in Massachusetts after reform was a significant reduction in deaths from the kinds of illnesses where we expect health care to have the biggest impact, including infections, cancer, and cardiovascular disease.â€ť
Sommers and his team, including senior author Katherine Baicker, professor of health economics at HSPH, and economist Sharon Long of the Urban Institute, examined theÂ changes in mortality rates for adults ages 20 to 64 in Massachusetts before the stateâ€™s health reform was implemented (2001 to 2005) and after (2007 to 2010). According to the study:
The researchers compared the changes in Massachusetts counties to changes in demographically similar counties in other states that had not enacted health reform during the same period. Data came from the U.S. Centers for Disease Control and Prevention and the Census Bureau.
The researchers found that the decline in mortality was concentrated among causes of death most likely to be preventable or treatable with timely health care, and they found that Massachusetts counties with lower median incomes and a higher percentage of uninsured adults before the law was passedâ€”areas likely to have experienced the greatest increase in access to care under reformâ€”gained the largest health benefits. In addition, the decline in mortality was nearly twice as large for minorities as it was for whites.
â€śOur findings add to a growing body of evidence showing that health insurance makes a positive difference in peopleâ€™s lives,â€ť Sommers said in a statement. â€śHow closely the impact of the Affordable Care Act will mirror the Massachusettsâ€™ experience is something weâ€™ll have to continue watching closely, but this is certainly encouraging news for the lawâ€™s potential impact on public health.â€ť
The results also showed that after the expansion there were fewer adults in Massachusetts without insurance, fewer cost-related barriers to care, more outpatient visits, and improvements in self-reported health.
UPDATED May 6, 10:35 a.m.: As pointed out by Yoni Appelbaum, a historian and doctoralÂ candidate at BrandeisÂ University, based on the math of 8.2 per 100,000 people, the number of preventedÂ deaths should be approximately 350Â by now, up from the previously reported 320.
Source URL: http://www.bostonmagazine.com/health/blog/2014/05/06/health-reform-works-study-says/