Employer Coverage Strengthening In MA

A new study shows that access to employer-sponsored health insurance (ESI) has remained strong in Massachusetts. The study finds no evidence that employers are dropping coverage or tightening eligibility for coverage of their workers. Additionally, the study offers no evidence that the care available under employers sponsored coverage has deteriorated. In fact, study participants rated the scope of services and quality of care available under their employer coverage more highly under health reform than before.

The study, conducted by Urban Institute researchers Sharon K. Long and Karen Stockley, uses data from three surveys of 4,000 Bay State workers between the ages of 18 and 64. The brief is the latest in a series funded by Blue Cross Blue Shield of Massachusetts Foundation, the Commonwealth Fund, and the Robert Wood Johnson Foundation on implementation of the Massachusetts reforms. A summary is here.

Author Sharon Long summarizes her findings on a blog post today:

The bottom line? ESI was not weakened once health care reform took hold in Massachusetts, which now enjoys the country’s lowest rate of uninsurance. Indeed, ample evidence suggests that the 2006 health care reform law significantly boosted ESI coverage, countering the trend toward lower ESI coverage in the rest of country.

Specific Study Findings
Employers in Massachusetts are continuing to offer coverage to their workers. Although small employers are less likely than large employers to offer coverage in general and would be the group most likely to drop coverage under health reform, the share of workers employed by small firms that offer coverage remained stable since 2006. According to the study, there is no evidence that employers are tightening eligibility for coverage under reform by limiting their offerings to a subset of employees. In fact, there has been an increase in the share of workers who reported that they had an offer of health insurance from the employer since fall 2006

The majority of workers (roughly two-thirds to three-quarters) rated their employer-sponsored health plans as very good or excellent in terms of the range of services offered, the choice of doctors and other providers, and the overall quality of care available under the plan in all three years, with the levels of satisfaction significantly higher in fall 2008 than in fall 2006 for the rating of services. These increases may reflect firms expanding the benefit package to comply with the new standards for minimum creditable coverage.

Finally, there was no change in the shares of all workers reporting high out-of-pocket health care spending or unmet need for care because of costs between fall 2008 and fall 2006.

Overall the findings indicate that Massachusetts adults have experienced expanded access to employer-sponsored coverage, despite the economic downturn.
-Jaspreet Chowdhary