NCPA - National Center for Policy Analysis


June 18, 2008

Just a year after implementing a groundbreaking health reform initiative in Massachusetts, the uninsured population in that state has been slashed nearly in half (from 13 percent to 7 percent), according to a new report from the Urban Institute in Washington, D.C. 

However, industry observers say that the experience in Massachusetts could point to potential problems that other states, or the nation, could face if health coverage is expanded too rapidly, says Steve Davis, managing editor of AIS Health Business Daily.

For example:

  • The spike in demand for services from the newly insured has stretched Massachusetts' already-limited primary care providers even thinner; for instance, one clinic has a waiting list of 150 to 200 patients.
  • Other organizations have had difficulty in filling vacant primary care physician slots; the Massachusetts League of Community Health Centers (MLCHC) says 10 percent of primary care positions in health centers statewide are vacant.
  • The Urban Institute report found that the cost of the program was nearly $150 million more than the $869 million allocated for the program.

The experience in Massachusetts illustrates that access to insurance is not synonymous with access to care, says Devon Herrick, a senior fellow with the National Center for Policy Analysis.  Herrick says some of the problems residents of Massachusetts are experiencing are characteristic of what we can expect across the country if the uninsured population is reduced too quickly:

  • Health plans could find it difficult to contain medical costs if the legislation includes a guaranteed-issue mandate.
  • Health plans will not be able to increase premiums enough to offset the spike in utilization caused by a reform strategy.
  • Pent-up demand among the previously uninsured could lead to a surge in people seeking primary care services if a large percentage of the uninsured population were suddenly covered.

Source: Steve Davis, "Demands on Massachusetts Providers Illustrate Challenges of Covering the Uninsured," AIS Health Business Daily, June 18, 2008.


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