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Am J Public Health. 2013 Jun;103(6):e107-14. doi: 10.2105/AJPH.2012.300997. Epub 2013 Apr 18.

Change in health insurance coverage in Massachusetts and other New England States by perceived health status: potential impact of health reform.

Author information

1
Northrop Grumman, and the Division of Behavior Surveillance, Public Health Surveillance and Informatics Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Abstract

OBJECTIVES:

We examined the impact of Massachusetts health reform and its public health component (enacted in 2006) on change in health insurance coverage by perceived health.

METHODS:

We used 2003-2009 Behavioral Risk Factor Surveillance System data. We used a difference-in-differences framework to examine the experience in Massachusetts to predict the outcomes of national health care reform.

RESULTS:

The proportion of adults aged 18 to 64 years with health insurance coverage increased more in Massachusetts than in other New England states (4.5%; 95% confidence interval [CI] = 3.5%, 5.6%). For those with higher perceived health care need (more recent mentally and physically unhealthy days and activity limitation days [ALDs]), the postreform proportion significantly exceeded prereform (P < .001). Groups with higher perceived health care need represented a disproportionate increase in health insurance coverage in Massachusetts compared with other New England states--from 4.3% (95% CI = 3.3%, 5.4%) for fewer than 14 ALDs to 9.0% (95% CI = 4.5%, 13.5%) for 14 or more ALDs.

CONCLUSIONS:

On the basis of the Massachusetts experience, full implementation of the Affordable Care Act may increase health insurance coverage especially among populations with higher perceived health care need.

PMID:
23597359
PMCID:
PMC3698751
DOI:
10.2105/AJPH.2012.300997
[Indexed for MEDLINE]
Free PMC Article
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