Trends: How have employers responded to health reform in massachusetts? Employees' views at the end of one year

Health Affairs

Volumn 27, Issue 6, 2008, Pages

  Long, Sharon K ^a   Masi, Paul B ^a  

^a URBAN INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; EMPLOYEE; EMPLOYEE ATTITUDE; EMPLOYER; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SURVEY; HUMAN; MAJOR CLINICAL STUDY; PUBLIC OPINION; UNITED STATES; ADOLESCENT; ECONOMICS; INFORMATION PROCESSING; MIDDLE AGED; UTILIZATION REVIEW;

ADOLESCENT; ADULT; DATA COLLECTION; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH CARE REFORM; HUMANS; MASSACHUSETTS; MIDDLE AGED; YOUNG ADULT;

EID: 56649103613     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.27.6.w576     Document Type: Article

References (19)

1. Commonwealth of Massachusetts, "Chapter 58 of the Acts of 2006," http://www.mass.gov/legis/laws/seslaw06/sl060058.htm (accessed 15 August 2008). Failure to set up a Section 125 plan can lead to a "free-rider surcharge" if the employer's workers use substantial amounts of care under the state's health care safety net.
2. A fair and reasonable contribution is defined as either (1) covering at least 25 percent of employees or (2) contributing at least 33 percent of the total premium for coverage.
3. S.K. Long, "On the Road to Universal Coverage: Impacts of Reform in Massachusetts at One Year," Health Affairs 27, no. 4 (2008): w270-w284 (published online 3 June 2008; 10.1377/hlthaff.27.4.w270).
4. J.R. Gabel, H. Whitmore, and J. Pickreign, "Report from Massachusetts: Employers Largely Support Health Care Reform, and Few Signs of Crowd-Out Appear," Health Affairs 27, no. 1 (2008): w13-w23 (published online 14 November 2007; 10.1377/hlthaff.27.1.w13).
5. This survey has been updated; see J.R. Gabel et al., "After the Mandates: Massachusetts Employers Continue to Support Health Reform as More Firms Offer Coverage," Health Affairs 27, no. 6 (2008): w566-w575 (published online 28 October 2008; 10.1377/hlthaff.27.6.w566).
6. See S.K. Long, "The Massachusetts Health Reform Survey," 15 April 2008, http://www.urban.org/publications/411649.html (accessed 15 September 2008).
7. There has been a downward trend in response rates for telephone surveys occurring nationally. See R. Curtin, S. Presser, and E. Singer, "Changes in Telephone Survey Nonresponse over the Past Quarter Century," Public Opinion Quarterly 69, no. 1 (2005): 87-98.
8. For information on recent survey response rates, see State Health Access and Data Assistance Center, "Are Low Response Rates Hazardous to Your Health Survey?," Issue Brief no. 13, February 2008, http://www.shadac.umn. edu/img/assets/18528/IssueBrief13.pdf (accessed 3March 2008).
9. The fall 2006 sample was being fielded as the CommCare program was beginning for adults with incomes under 100 percent of the federal poverty level. Enrollment in that program started slowly and was relatively low in fall 2006.
10. L.B. Mohr, Impact Analysis for Program Evaluation, 2d ed. (Thousand Oaks, Calif.: Sage Publications, 1995).
11. The share of working-age adults in Massachusetts who were employed was stable at 64 percent in both fall 2006 and fall 2007 (and into spring 2008). Data available at Mass.gov, "Labor Force and Unemployment Data," http://lmi2.detma.org/Lmi/lmi_lur_a.asp (accessed 10 April 2008).
12. Further, the Federal Reserve's Beige Book, which provides an assessment of local economic conditions, reported that the economy for the Boston region was generally stable in 2007. See Federal Reserve Board, "The Beige Book: Federal Reserve Districts: First District-Boston," 28 November 2007, http://www.federalreserve.gov/FOMC/BEIGEBOOK/2007/20071128/1.htm (accessed 18 April 2008).
13. Data from the 2006 Medical Panel Expenditure Survey Insurance Component (MEPS IC). See Agency for Healthcare Research and Quality, Summary Data Tables, Table II.C.2, http://www.meps.ahrq.gov/mepsweb/data_stats/summ_tables/insr/ state/series_2/2006/tiic2.htm (accessed 15 September 2008);
14. and Table II.D.2, http://www.meps.ahrq.gov/mepsweb/data_stats/ summ_tables/insr/state/series_2/2006/tiid2.htm (accessed 15 September 2008).
15. Workers were asked to rate their plans using a scale of excellent, very good, good, fair, or poor.
16. The information on problems with high health care costs is based on the following question: "I'm going to read you a list of problems some people experience with their health insurance coverage. Please tell me if you have had these problems with your health insurance coverage in the last 12 months. (1) 'You had expensive medical bills for services NOT covered by your health insurance.' Has this happened to you in the past 12 months? (2) 'Your doctor charged you a lot more than your health insurance would pay and you had to pay the difference.'Has this happened to you in the past 12 months?"
17. Out-of-pocket costs tend to be higher for those with family coverage than those with single coverage. Consistent with the findings for the overall population of workers, when we looked separately at changes in out-of-pocket costs by coverage type, we found no evidence of increases in these costs between fall 2006 and fall 2007.
18. Gabel et al., "Report from Massachusetts."
19. R.C. Heriot and R.D. Hatfield, "A Framework for Assessing the Need for Legal Readiness in Small and Entrepreneurial Firms," Entrepreneurial Executive 9 (2004): 17-30.