Individual health insurance mandate: Insights from Massachusetts

While many people are worried about the impact of the Patient Protection and Affordable Care Act's requirement that most Americans have health insurance, the individual health insurance mandate passed by the Massachusetts Legislature in April 2006 has not driven the cost of hospital care higher, according to "The Impact of an Individual Health Insurance Mandate on Hospital And Preventive Care: Evidence From Massachusetts," a new working paper from researchers at the National Bureau of Economic Research (NBER). The researchers examined hospital data to determine how the Massachusetts insurance requirement impacted insurance coverage, healthcare utilization patterns and patient outcomes in the state compared to outcomes in the state before the reform and to outcomes in other states.

The rate of uninsurance among hospital discharges was 28 percent less post-reform vs. pre-reform. With the mandate in place, patients had shorter hospital stays and experienced fewer inpatient admissions that originated in the emergency department. In addition, outpatient care reduced hospitalizations for preventable conditions. But researchers found "no evidence" supporting an associated increase in the cost of hospital care.

In related news from the Commonwealth, the Massachusetts Supreme Judicial Court recently ruled that the state doesn't have to consider whether workers can afford to pay for employer-sponsored health insurance when determining if they are eligible for a waiver to participate in the state-sponsored Commonwealth Care insurance program, reports the American Medical News.

To learn more:
- review the NBER working paper
- read the American Medical News article

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