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Journal Article


Improvements in Health Status After Massachusetts Health Care Reform

The Issue

In 2006, Massachusetts enacted health care reforms to expand insurance coverage and improve access to care. Since then, some 400,000 residents have gained coverage, and 98 percent of the state’s population is now insured. In Milbank Quarterly, former Commonwealth Fund Harkness Fellow Philip J. Van der Wees and coauthors examine whether these reforms also resulted in better health status and increased access to preventive health services for Massachusetts residents.

What the Study Found

The researchers used data from a state-based survey to look at self-reported health status and use of preventive services for 345,211 adults from 2001 to 2011. Relative to other New England states, Massachusetts residents reported gains in general health (1.7%), physical health (1.3%), and mental health (1.5%). Massachusetts residents were also more likely to access key preventive services such as Pap screening, colonoscopy, and cholesterol testing. Lower- and middle-income residents appeared to benefit most from reform: adults in households that earned up to 300 percent of the federal poverty level (approximately $70,000 for a family of four) were 6.1 percent more likely to be insured than those in neighboring states and reported greater gains in health status.


While acknowledging that additional studies are needed to determine if these trends are consistent in the long term, the authors note that similar benefits might be associated with implementation of the Affordable Care Act.

Publication Details



P. J. Van der Wees, A. M. Zaslavsky, and J. Z. Ayanian, "Improvements in Health Status After Massachusetts Health Care Reform," Milbank Quarterly, Dec. 2013 91(4):663–89.