A new state survey released today shows that the number of MA uninsured dropped from 460,000 in 2004 to 372,000 in 2006, a 19% decrease, giving the state a six percent uninsurance rate, among the nation’s best. Click here for the state press release.

The survey shows a substantial drop for adults (10.6 to 8.7%) and kids (3.2 to 2.5%). Every region of the state showed a drop: Northeast 9.7 to 5.7%; Worcester 7.0 to 5.6%; Greater Boston 7.8 to 6.6%; Southeast 8.9 to 8.5%; and Western Mass 7.8 to 7.7%. Results based on ethnicity were mixed: Whites down 6.3 to 5.1%; Hispanics down 15.1 to 12.8%; Asians down 4.0 to 3.1%, and African Americans up 7.5 to 13.4%. This last number is an eye-popping puzzle that may relate to a small sample size. Unfortunately, back up details won’t be made available by the state until the fall.

State officials estimate that 50,000 of the lower number of uninsured got coverage through MassHealth. This rings true to us. They estimate the other 38,000 got coverage as new jobs were added and workers got employer based coverage (our economy added about 40,000 new jobs during the 2-year period). This may be true, but seems less solid to us than the Medicaid estimate.

Some quick observations:

1. Why did the state release these numbers when the backup was not ready? Because tomorrow the US Census Bureau releases national and state-by-state estimates of the uninsured. These numbers are always higher than state surveys. Last year’s Current Population Survey (CPS) estimate for MA was about 750,000 uninsured. Seems like the Romney Administration wanted to rush its own numbers out just before the less rosy federal estimates arrived.

2. We agree with the Romney Administration that the state survey is probably closer to the truth than the CPS numbers because the CPS survey is well known for undercounting folks enrolled in state Medicaid programs. The CPS number is useful for setting a national estimate, and for allowing states to compare their rates relative to each other. It’s less helpful in providing a real number and real rate of uninsured in any single state.

3. We’re not sold that 372,000 is the real number. The Urban Institute in 2005 did their own analysis comparing the 2004 State survey and the CPS data and came up with their own estimate of 532,000 uninsured in 2004. Our sense is that the UI number is probably the most reliable, and that would indicate the 372,000 may be somewhat low.

4. Low or not as the absolute number, the trend represents good news. A lower number of uninsured means the challenge of implementing Chapter 58, the new health reform law, will be less expensive than anticipated or feared. For everyone who wants the new law to work, it’s undeniably good news.

5. These numbers are the proof: the Romney Administration deserves credit for doing a good job enrolling folks in MassHealth — through the Virtual Gateway, by requiring determination of MassHealth eligibility before getting care through the Uncompensated Care Pool, and more. This validates the strategy of using MassHealth as a key tool in reducing the uninsurance rate.

6. Regardless of the actual number, if the CPS numbers tomorrow show a downward trend in uninsured numbers in MA, that is important confirmation of the validity of these state numbers. If the CPS numbers are trending upward, it’s time for head scratching.

John McDonough