Romneycare Improved Health in Massachusetts: Study

Study links broader health insurance with better health and care
December 13, 2013 Updated: December 15, 2013

A recent 10-year study found Massachusetts residents had better health and better health care since the state’s health care reform in 2006, which expanded insurance coverage for the low-income population. The reform, nicknamed “Romneycare,” was signed into law by then-Gov. Mitt Romney. The Affordable Care Act, nicknamed “Obamacare,” was modeled on the Massachusetts law.

“The mandate for all residents to purchase insurance coverage implies that insurance providers have to accept new applicants to their health plans based on minimum standards,” wrote the study’s co-author Philip Van der Wees, Ph.D., senior researcher at Radboud University Nijmegen Medical Center in the Netherlands, in an email interview. “In Massachusetts, the Commonwealth Health Insurance Connector Authority acted as an exchange where regulated private insurance plans were offered to mostly previously uninsured residents.” Van der Wees was at Harvard during the study.

The study, “Improvements in Health Status after Massachusetts Health Care Reform,” lasted from 2001 to 2011. It was published in the latest issue of Milbank Quarterly.

Telephone interviews were conducted with 345,211 adults to collect information about their general physical, and mental health. The study also measured use of preventive screenings such as mammograms, PAP tests, colonoscopies, or cholesterol testing to predict heart disease risk. Data was gathered by the state health departments and the Centers for Disease Control and Prevention.

Health Care Reform May Equal Better Health

After broader insurance coverage became available, residents of Massachusetts reported significant improvements in general, physical, and mental health, especially among those whose income was within 300 percent of the federal poverty level.

“Our results demonstrate the potential benefits of health care reform in Massachusetts that may also be achieved through the implementation of the federal Affordable Care Act,” stated study co-author John Z. Ayanian, M.D., MPP, director of the University of Michigan’s Institute for Healthcare Policy and Innovation, in a press release.

Expansion for Millions

“The implementation of the Affordable Care Act will provide expansion of insurance coverage for millions of residents,” wrote Van der Wees. “Differences between states are big and the impact of broader health insurance coverage may be related to specific developments at state level.” 

“However, our results at state level in Massachusetts demonstrate the potential benefits of health care reform at national level,” he added. 

According to Van der Wees, the study shows that the expansion of insurance coverage for people with low income improved access to health care and also improved health. In earlier studies, similar results were found for uninsured people who became eligible for Medicare. 

The editor of the Milbank Quarterly, University of Massachusetts Medical School professor Howard Markel, M.D., Ph.D., called the study an important contribution to the understanding of the potential implications of the federal Affordable Care Act, in a statement from the University of Michigan Health System.

“In an era of demagoguery and exaggeration posing as ‘facts’ it is essential to collect and analyze solid evidence on our nation’s health care policies,” said Markel.